Title:Traumatic Chylothorax due to Cervical Stab Wound: A Case Report
Volume: 5
Author(s): Gabriela Karabachian Tebar, Rafael de Lima Silva, Thiago Gaspar, Vitor Hernandes Lopes, Vinicius Vertematti de Castro, Jose Mauro da Silva Rodrigues and Marcelo A. F. Ribeiro Junior*
Affiliation:
- Department of Surgery, Division of Trauma and Acute Care Surgery, Pontifical Catholic University of Sao Paulo – Campus Sorocaba, Brazil
- Trauma, Critical Care and Acute Care Surgery at Sheikh Shakhbout Medical City – Mayo Clinic, Abu Dhabi, UAE
- Khalifa University and Gulf Medical University, Ajman, UAE
Keywords:
Thoracic duct, Chylothorax, Cervical trauma, Chest X-ray, Stab wound, Pulmonary embolism.
Abstract:
Background:
Chylothorax corresponds to the incidence of chyle in the pleural space; it was described for the first time in 1633. Its most common cause is
associated with iatrogenic injuries to the thoracic duct; 80% of them take place during surgeries, such as pneumonectomy or esophagectomy.
Case presentation:
A case of an unusual cervical stab wound complication in a 23-year-old man who presented a late large volume chylothorax has been presented
and discussed in this paper, as well as its management.
Discussion:
The presented case demonstrates a rare complication after a cervical stab wound. The management of chylothorax can involve non-operative
management, non-operative intervention, or operative management depending on the symptoms and duration. Usually, surgical interventions are
required after two weeks of clinical treatment. The differential diagnosis in a post-trauma acute onset ventilatory manifestation is mandatory to rule
out pulmonary embolism.
Conclusion:
Traumatic chylothorax is a rare event; however, its morbidity and mortality rates can be catastrophic when it is not diagnosed early and when the
treatment is not established based on a proper flowchart. Thus, dietary and drug-based clinical measures, interventional radiology,
videothoracoscopy, and thoracotomy for thoracic duct ligation are valid therapeutic options for the proper management of these cases.
