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Antes Revista del Instituto Nacional de Enfermedades Respiratorias

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2019, Number 2

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Neumol Cir Torax 2019; 78 (2)

Traumatic chylothorax and its surgical resolution, a rare entity. A case report

Vázquez‑Minero JC, Arciniega‑Belmont S, Meza‑Félix E, Hernández‑García A, Flores‑Huerta V, Morales‑Villalobos R, Trueba‑Lozano D

Language: Spanish
References: 12
Page: 139-142
PDF size: 327.00 Kb.


ABSTRACT

Chylothorax is defined as the accumulation of chyle in the pleural cavity. The non-iatrogenic traumatic etiology occurs in 0.2 to 3% of all cases. We introduce the case of an 18-year-old male who was admitted with history of aggression with a sharp-pointed instrument, which resulted in initial right anterolateral thoracotomy with pulmonary injury hemostasis and right posterior paravertebral diaphragmatic sinus rhaphy. During the PO period, the chest-tube developed high output of chyle-like fluid. The diagnosis was corroborated with cytochemical study demonstrating triglycerides 243 mg/dl. Conservative management was attempted with fasting and parenteral nutrition, but the output remained on 1,000 cm3 on the fifth post operatory day with imaging showing cavity and fluid accumulation despite these measures. Surgical management with pleurodesis was performed. The patient had an adequate evolution; on the five post operatory day the patient started oral nutrition without new chylothorax evidence, the chest-drainage was removed and the patient discharged on seven day.


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