Srpski arhiv za celokupno lekarstvo 2017 Volume 145, Issue 1-2, Pages: 73-76
https://doi.org/10.2298/SARH160218015S
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A rare case of traumatic chylothorax after blunt thoracic trauma
Spasić Marko 
(Clinical Center Kragujevac, Clinic for General and Thoracic Surgery, Kragujevac + Faculty of Medical Sciences, Kragujevac)
Arsenijević Miloš (Clinical Center Kragujevac, Clinic for General and Thoracic Surgery, Kragujevac + Faculty of Medical Sciences, Kragujevac)
Dončić Nikola (Clinical Center Kragujevac, Clinic for General and Thoracic Surgery, Kragujevac)
Mrvić Stanko (Clinical Center Kragujevac, Clinic for General and Thoracic Surgery, Kragujevac)
Stojković Dragan (Clinical Center Kragujevac, Clinic for General and Thoracic Surgery, Kragujevac)
Milošević Bojan (Clinical Center Kragujevac, Clinic for General and Thoracic Surgery, Kragujevac + Faculty of Medical Sciences, Kragujevac)
Milisavljević Slobodan (Clinical Center Kragujevac, Clinic for General and Thoracic Surgery, Kragujevac + Faculty of Medical Sciences, Kragujevac)
Introduction. Chylothorax is an accumulation of chyle in the pleural cavity due to a disruption of the thoracic duct. Traumatic chylothoraces are usually a result of a penetrating trauma and disruption of the thoracic duct, but blunt traumatic chylothorax is a rare condition. The aim of this paper is to present a rare case of traumatic chylothorax after blunt thoracic trauma. Case Outline. We present a case of traumatic chylothorax after blunt thoracic trauma in a patient injured in a motor vehicle accident. The patient had a right-sided fracture of rib XI, hydropneumothorax, lung contusion, and signs of pneumomediastinum. We performed thoracic drainage, but a few days later, according to the increase of amount of the fluid daily drained, and the confirmation of laboratory findings of the analyzed fluid, we made a diagnosis of chylothorax and the patient underwent a thoracotomy, where we sutured the thoracic duct. Conclusion. Chylothorax should be considered in patients after chest trauma if they develop a milky pleural effusion. Analysis of pleural fluid and level of triglycerides is important for the diagnosis and treatment of chylothorax.
Keywords: chylothorax, surgery, thoracic trauma, Thoracotomy
Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III41007