Delayed Chylothorax Following Blunt Chest Trauma Treated with Repeated Lymphangiography: A Case Presentation

Gayoung Kim, Dongsub Noh, Bong Man Kim, Yoonjung Heo
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Abstract

Chylothorax is mostly iatrogenic, with blunt chest trauma being a rare cause. Treatment depends on the volume of drainage. Specifically, conservative treatment, such as total parenteral nutrition and pleural drainage, is performed in cases of low daily output (< 500 mL/day). Patients with persistent chylothorax despite medical treatment or with high daily output (> 1-1.5 L/day) are candidates for surgical or radiological intervention. We present a case of delayed-onset chylothorax after blunt trauma caused by thoracic spine fractures, in which persistent chylothorax was successfully managed with repeated lymphangiography with lipiodol when other treatment modalities failed. The case is peculiar in that the chylothorax occurred 40 days after the initial traumatic event and was treated with lipiodol injection, despite maintaining moderate to high daily output.
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反复淋巴管造影治疗钝性胸外伤后迟发性乳糜胸1例
乳糜胸大多是医源性的,钝性胸部创伤是一种罕见的原因。处理取决于排水量。具体而言,在日产量低(<500mL/天)的情况下,进行保守治疗,如全胃肠外营养和胸膜引流。尽管进行了药物治疗,但仍有持续性乳糜胸的患者或日产量高(>1-1.5升/天)的患者可进行手术或放射干预。我们报告了一例由胸椎骨折引起的钝性创伤后迟发性乳糜胸,在其他治疗方式失败的情况下,通过碘油重复淋巴管造影成功治疗了持续性乳糜胸。该病例的特殊之处在于,乳糜胸发生在最初的创伤事件后40天,尽管维持了中等至高的日产量,但仍用碘油注射治疗。
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