During a high-speed road traffic accident, a 26-year-old man suffered multiple fractures of his thoracic vertebrae and bilateral pneumothoraces. The day after admission and commencement of nasogastric feeding, milky fluid was noted in his right chest drain. Feeding was stopped and a contrast oesophogram and oesophagoscopy were performed, which were normal. The chylothorax quickly resolved and both drains were removed on day 6. Initial treatment of chylothorax aims to decompress the pleural space and minimise chyle production by not feeding the patient via the enteral route. Most authors recommend conservative management for 2 weeks or more unless certain parameters are met: average daily chyle loss of > 1.5 l for a 5-day period, or imminent nutritional complications. In this case, surgical management of the chylothorax and spinal fractures was planned. However, conservative management was successful, highlighting the fact that early aggressive surgical intervention for chyle leaks in blunt trauma is not necessary. (+info)
Spontaneous chylothorax associated with light physical activity.
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Chylothorax occurs when there is rupture, laceration or obstruction of the thoracic duct, resulting in the release of chyle into the pleural space. Chylothorax can occur in cases of congenital lymphatic malformation, lymphoma, mediastinal tumor and infectious disease, as well as during surgical procedures and after traffic accident-related trauma. It can also be idiopathic. The condition presents clinical signs of dyspnea, hypotension, generalized edema and cyanosis. The diagnosis is usually made through thoracocentesis, and the treatment is conservative. Spontaneous chylothorax is an uncommon form of pleural effusion, and its diagnosis should be hypothesized only after all other causes have been ruled out. Herein, we describe a case of spontaneous chylothorax associated with light physical activity at a fitness center. (+info)
Late-period-onset chylothorax after a pulmonary resection for lung cancer: a case report.
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A 65-year-old female had been diagnosed with right lung cancer by her family physician, and she was introduced to our Department of Thoracic Surgery at Matsuyama Red Cross Hospital in May 2004. She underwent a right upper lobectomy and wedge resection of S6 with the systematic dissection of her mediastinal lymph nodes. The patient made an uneventful recovery and was discharged on postoperative day 19. However, chylothorax was detected on a chest roentgenogram when she consulted our outpatient clinic again for dyspnea on exertion and chest pain. Chylothorax occurred in postoperative day 34. The patient initially received conservative therapy, but subsequently underwent surgical treatment and fibrin glue intubation when conservative therapy proved to be unsuccessful. (+info)
Isolated thoracic duct injury in penetrating neck trauma: a case report.
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A 39-year-old man was admitted with a stab wound to left lower neck. Chest X-ray revealed a left hydropneumothorax. Thoracentesis was performed and analysis of the fluid revealed chyle. Patient was treated conservatively by closed chest drainage and total parenteral nutrition. On the basis of this clinical report and review of the literature, it is concluded that thoracic duct injury should be kept in mind in penetrating neck trauma and conservative treatment should be the first line therapy. (+info)
Report of three cases: congenital chylothorax and treatment modalities.
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Chylothorax is the most common cause of pleural effusion in the newborn. We report three patients with congenital chylothorax and discussed the clinical course and treatment options. Cases 1 and 2 with congenital chylothorax were treated by chest tube placement and total parenteral nutrition (TPN), and were fed a formula rich in medium-chain triglyceride. They were discharged home without any sequelae. Our 3rd case with chylothorax did not respond to the conventional therapies. Octreotide infusion was tried without any benefits and necessitated surgical intervention, but the infant developed chronic lung disease requiring nasal oxygen therapy until three months of age. All three patients developed complications of chylothorax treatment like chest tube dysfunction, pneumothorax, nosocomial sepsis, and cholestasis. Management of congenital chylothorax necessitates a multidisciplinary approach. Treatment options include pleural drainage, cessation of enteral feeding and initiation of TPN. Experience with octreotide treatment is limited. Surgery should be reserved for severe and refractory cases. (+info)
A case of chylothorax treated curatively with Sapylin, a streptococcus preparation.
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Chylothorax--a conservative approach (a case report).
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Lymphatic blockage due to a non-specific inflammation probably of a filarial origin caused dilatation and ectasia of lymph channels at thoracic inlet of a child. Transudation of lymph through these channels led to chylothorax. The present case report highlights the significance of conservative approach towards this complex problem. (+info)
Post-esophagectomy chylous leakage from a duplicated left-sided thoracic duct ligated successfully with left-sided video-assisted thoracoscopic surgery.
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