Milano S, Maroldi R, Vezzoli G, Bozzola G, Battaglia G, Mombelloni G
Department of Thoracic and Cardiovascular Surgery, Civili Hospital, Brescia, Italy.
Thorac Cardiovasc Surg. 1994 Jun;42(3):187-90. doi: 10.1055/s-2007-1016485.
We report on a case of closed chest trauma with an unusual latent period of 11 weeks in a woman 26 years old. The patient had a dual thoracic duct with a dual lesion and was evaluated using lymphography and CT. We discuss the pathogenetic mechanism and the unusual radiological appearance with discontinuity of the duct, and an increase in back pressure which promotes dilatation of lymphatic vessels and nodes. The dual duct had two separate traumatic consequences: a chyloma on the right and leakage in the pleura on the left. Pleuroperitoneal shunting was effective after failure of conservative treatment. Two years after discharge the patient is asymptomatic with normal chest X-ray image. She is near term in a normal pregnancy and without signs of silent malignancy.
我们报告一例26岁女性的闭合性胸部创伤病例,其潜伏期长达11周,情况较为罕见。该患者存在双胸导管且均有损伤,通过淋巴管造影和CT进行了评估。我们讨论了发病机制以及导管连续性中断的异常放射学表现,还有促进淋巴管和淋巴结扩张的背压升高情况。双导管产生了两种不同的创伤后果:右侧形成乳糜瘤,左侧胸膜出现渗漏。保守治疗失败后,胸膜腹膜分流术取得了良好效果。出院两年后,患者无症状,胸部X线影像正常。她目前处于正常妊娠晚期,未出现隐匿性恶性肿瘤的迹象。