J Korean Soc Traumatol.  2019 Jun;32(2):107-110. 10.20408/jti.2018.050.

Bilateral Chylothorax Due to Blunt Spine Hyperextension Injury: A Case Report

• Lee H
• Han SH
• Lee MK
• Kwon OS
• Kim KH
• Kim JS
• Chon SH
• Shinn SH

• KMID: 2462945
• DOI: http://doi.org/10.20408/jti.2018.050

Abstract

Bilateral chylothorax due to blunt trauma is extremely rare. We report a 74-year-old patient that developed delayed bilateral chylothorax after falling off a ladder. The patient had a simple 12th rib fracture and T12 lamina fracture. All other findings seemed normal. He was sent home and on the 5th day visited our emergency center at Halla Hospital with symptoms of dyspnea and lower back pain. Computer tomography of his chest presented massive fluid collection in his right pleural cavity and moderate amounts in his left pleural cavity with 12th rib fracture and T11-12 intervertebral space widening with bilateral facet fractures. Chest tubes were placed bilaterally and chylothorax through both chest tubes was discovered. Conservative treatment for 2 weeks failed, and thus, thoracic duct ligation was done by video assisted thoracoscopic surgery. Thoracic duct embolization was not an option. Postoperatively, the patient is now doing well and happy with the results. Early surgical treatment must be considered in the old patient, whom large amounts of chylothorax are present.

Keyword

Chylothorax; Blunt injury; Video assisted thoracoscopic surgery

MeSH Terms

Accidental Falls
Aged
Chest Tubes
Chylothorax*
Dyspnea
Emergencies
Humans
Ligation
Low Back Pain
Pleural Cavity
Rib Fractures
Spine*
Thoracic Duct
Thoracic Surgery, Video-Assisted
Thorax
Wounds, Nonpenetrating