J Korean Soc Emerg Med.  2006 Dec;17(6):659-663.

A Case of Chylothorax after Blunt Chest Trauma Accompanied by Nephrotic Syndrome

• Lee SB
• Lee SH
• Kim JH
• Lee JY
• Si JW
• Do BS

Abstract

Chylothorax after blunt chest trauma is very rare and is generally caused by injuries to the thoracic duct or its major tributaries. Such an injury can cause a fistula, a localized collection of chyle known as a chyloma, or an intrapleural collection referred to as a chylothorax. We report a case of chylothorax attributed to thoracic duct injury after an in-car traffic accident, accompanied by nephrotic syndrome diagnosed after admission. An 11-year-old male was admitted because of dyspnea developed three days previously after an in-car traffic accident. He also complained of nausea, vomiting, and abdominal discomfort after meals. We took chest X-ray films and a chest CT scan in the emergency department, which showed pleural effusion on both sides and massive ascites. Diagnostic thoracentesis was then done, the aspirated fluid showed a milky-white appearance and fluid analysis showed chyle. Tube thoracostomy with fluid and nutritional support was administered but a week later the patient was more edematous and laboratory results revealed nephrotic features. After a further ten days, the patient was discharged with some symptomatic improvement, not confirmed by pathologic diagnosis.

Keyword

Chylothorax; Blunt injury; Thoracic Duct; Nephrotic Syndrome

MeSH Terms

Accidents, Traffic
Ascites
Child
Chyle
Chylothorax*
Diagnosis
Dyspnea
Emergency Service, Hospital
Fistula
Humans
Male
Meals
Nausea
Nephrotic Syndrome*
Nutritional Support
Pleural Effusion
Thoracic Duct
Thoracostomy
Thorax*
Tomography, X-Ray Computed
Vomiting
Wounds, Nonpenetrating
X-Ray Film