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Tube thoracostomy: One-off cause of chylothorax
Marcio Botter1, Gustavo Yamin2, Raul R Ururahy2
1Thoracic Surgery Department, Irmandade da Santa Casa de Misericórdia de São Paulo, R. Dr. Cesário Mota Júnior, 112 - Vila Buarque, São Paulo 01221-020, SP, Brazil.
Trauma Case Reports
|April 24, 2019
Summary
Chylothorax, a rare complication of thoracic drainage, occurred in a patient with a chest injury. The drainage tube compressed the thoracic duct, leading to milky fluid accumulation.
Area of Science:
- Thoracic Surgery
- Medical Complications
- Diagnostic Imaging
Background:
- Chylothorax is an uncommon condition resulting from the leakage of chyle into the pleural space.
- Thoracic duct injury is a known, albeit rare, cause of chylothorax.
- This case highlights a unique etiology of chylothorax secondary to thoracic drainage.
Observation:
- A patient presented with a right hemithorax metal fragment and pneumothorax after a power tool accident.
- Following thoracic drainage, the patient developed milky pleural effusion, confirmed as chylothorax.
- Videothoracoscopy revealed the drainage tube was compressing the thoracic duct.
Findings:
- Thoracic duct compression by a drainage tube is a potential cause of iatrogenic chylothorax.
- This represents a rare instance of chylothorax following chest trauma and intervention.
- Diagnostic confirmation involved laboratory analysis of pleural fluid and direct visualization via videothoracoscopy.
Implications:
- This case underscores the importance of careful drainage tube placement to avoid thoracic duct injury.
- It expands the differential diagnosis for chylothorax in patients with chest trauma and thoracic procedures.
- Awareness of this complication may improve early diagnosis and management of similar cases.
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