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钝性创伤后双侧大量乳糜胸

Massive bilateral chylothorax post blunt trauma.

作者信息

Kozul Christina, Jassal Karishma, Judson Rodney

机构信息

Department of Trauma, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.

出版信息

Trauma Case Rep. 2017 Nov 6;12:63-65. doi: 10.1016/j.tcr.2017.10.024. eCollection 2017 Dec.

Abstract

Chylothorax caused by blunt trauma is extremely rare. We present a case of bilateral massive chylothorax post blunt trauma and a review of the literature regarding the identification and management of this rare diagnosis. An eighteen-year-old male was involved in a motor vehicle crash where he sustained multiple injuries including a right, moderate to large, haemopneumothorax, a small left haemopneumothorax, left T8, T9, L1 and L2 acute transverse process fractures and fractures of bilateral 11th ribs. An intercostal catheter was inserted on the right side which initially drained blood-stained fluid however milky colour fluid was noted to be draining 11 h post insertion. Further imaging revealed a left pleural effusion causing a mediastinal shift where, once drained, also revealed a chylothorax. The patient was managed conservatively with bilateral intercostal catheters and a no fat/low-fat diet. The patient was discharged day seven post removal of bilateral intercostal catheters.

摘要

钝性创伤所致乳糜胸极为罕见。我们报告一例钝性创伤后双侧大量乳糜胸病例,并对有关这一罕见诊断的识别与处理的文献进行综述。一名18岁男性遭遇机动车碰撞事故,全身多处受伤,包括右侧中至大量血气胸、左侧少量血气胸、左侧第8、9、11和12胸椎急性横突骨折以及双侧第11肋骨骨折。右侧置入一根肋间导管,最初引出血性液体,但置管11小时后引出乳白色液体。进一步影像学检查显示左侧胸腔积液导致纵隔移位,引流后也发现为乳糜胸。患者采用双侧肋间导管及无脂/低脂饮食进行保守治疗。双侧肋间导管拔除后第7天患者出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b612/5887095/df832ea12e67/gr1.jpg

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