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Compressive chylothorax after lumbar spine fracture.

P Meignan1, W Lakhal2, A Binet1

  • 1Chirurgie viscérale pédiatrique, hôpital Clocheville, 49, boulevard Beranger, 37000 Tours, France.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|March 23, 2019
PubMed
Summary

A rare case of pediatric compressive chylothorax following blunt thoracic trauma and L1 Chance fracture was successfully managed conservatively after initial drainage. This highlights drainage as a key first step for rare post-traumatic complications.

Keywords:
Blunt traumaChylothoraxPediatricsSpine fracture

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Area of Science:

  • Trauma Surgery
  • Pediatric Surgery
  • Thoracic Surgery

Background:

  • High-energy blunt trauma can lead to severe spinal injuries.
  • Thoracic trauma may rarely result in compressive chylothorax, a serious complication.
  • Pediatric spinal fractures are less common than in adults, making associated complications rarer.

Observation:

  • A 14-year-old male sustained an L1 Chance fracture from blunt thoracic trauma.
  • Developed a compressive chylothorax 72 hours post-admission.
  • Initial surgical drainage was followed by successful conservative management.

Findings:

  • This case represents the first documented non-iatrogenic, post-traumatic compressive chylothorax in a pediatric patient managed conservatively.
  • Initial thoracic drainage proved both therapeutic and diagnostic.
  • Conservative management, including parenteral nutrition and a fat-free diet, resolved the chylothorax.

Implications:

  • Thoracic drainage is a crucial first-line approach for diagnosing and treating post-traumatic chylothorax.
  • Conservative management can be effective for pediatric compressive chylothorax after spinal fractures.
  • Surgical intervention is reserved for persistent cases unresponsive to conservative measures after 5-7 days.