J Acute Care Surg.  2023 Mar;13(1):39-42. 10.17479/jacs.2023.13.1.39.

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

• Kim G
• Noh D
• Kim BM
• Heo Y

• KMID: 2540679
• DOI: http://doi.org/10.17479/jacs.2023.13.1.39

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.

Keyword

chylothorax; lymphography; nonpenetrating wounds; spinal fractures; therapeutic embolization