Butscher K, Charpentier C, Audibert G, Grosdidier G, Laxenaire M C
Département d'anesthésie-réanimation chirurgicale, CHU Nancy, France.
Ann Fr Anesth Reanim. 1996;15(2):185-8. doi: 10.1016/0750-7658(96)85040-4.
Chylothorax following blunt chest trauma is a rare event. The presence of a cloudy or milky persistent pleural effusion should suggest the possibility of its chylous origin. The diagnosis is made by analysis of the fluid obtained either from thoracentesis or tube thoracostomy. A lymphangiogram can show the site of the lesion, but computed tomography is a more recent and probably as helpful diagnostic test. An efficient control of the chylous effusion may be facilitated by using a fat-poor enteral nutrition and parenteral nutrition, which prevents malnutrition. Surgical ligation of the thoracic duct is relatively simple and efficient. It is indicated when the daily chylous flow is over 500 mL after 2 or 3 weeks of medical treatment or in case of weight loss.