Meignan P, Lakhal W, Binet A, Le Touze A, De Courtivron B, Lardy H, Bonnard C, Odent T
Chirurgie viscérale pédiatrique, hôpital Clocheville, 49, boulevard Beranger, 37000 Tours, France.
Chirurgie orthopédique pédiatrique, hôpital Clocheville, 49, boulevard Beranger, 37000 Tours, France.
Arch Pediatr. 2019 Apr;26(3):168-170. doi: 10.1016/j.arcped.2019.02.012. Epub 2019 Mar 18.
A 14-year-old boy was admitted to the hospital after an episode of blunt trauma to the thorax, resulting in a Chance fracture of L1 and a compressive chylothorax 72h after admission. After initial drainage in the operating room, conservative management was successful. This case study documents one of the rare complications of spinal fractures in the context of high-energy blunt trauma. It is the first detailing a noniatrogenic post-traumatic compressive chylothorax in pediatrics responding positively to conservative management. Drainage should be considered the first-line procedure for both therapeutic and diagnostic purposes. Surgery is required if the leakage is still present after parenteral feeding and the implementation of a fat-free diet for 5-7 days.
一名14岁男孩在胸部遭受钝性创伤后入院,导致L1椎体Chance骨折,并在入院72小时后出现压迫性乳糜胸。在手术室进行初步引流后,保守治疗取得成功。本病例研究记录了高能钝性创伤背景下脊柱骨折罕见的并发症之一。这是第一例详细描述儿科非医源性创伤后压迫性乳糜胸且对保守治疗有积极反应的病例。出于治疗和诊断目的,引流应被视为一线治疗方法。如果在肠外营养及实施5 - 7天无脂饮食后仍有渗漏,则需要进行手术。