Chylomediastinum following tracheal surgery

Area of Science:

• Thoracic Surgery
• Surgical Complications
• Gastroenterology

Background:

• Chylomediastinum is a rare but severe complication following thoracic surgical procedures.
• Median sternotomy is a common surgical approach for tracheal resection.
• Early recognition and management are crucial for favorable outcomes.

Observation:

• A 70-year-old woman developed sternal dehiscence and chylous drainage two weeks after tracheal resection via median sternotomy.
• Conservative management included cessation of oral intake and initiation of total parenteral nutrition.
• The chylous drainage resolved after two weeks of conservative management.

Findings:

• Revision of sternotomy included ligation of the affected region with a purse-string suture.
• Tc-99 lymphoscintigraphy confirmed minimal lymph leakage, indicating thoracic duct injury.
• The patient experienced a full recovery and remained problem-free for nine months post-procedure.

Implications:

• This case underscores the importance of recognizing and managing chylomediastinum after thoracic surgery.
• Surgical intervention, such as ligation, can be effective in resolving persistent chylous leakage.
• Prompt diagnosis and appropriate treatment contribute to successful patient outcomes and recovery.