Chylothorax caused by blunt trauma: Case review and management proposal
Brandon T Bacon1,2, Wayne Mashas2
1Department of Surgery, University of Missouri-Kansas City, School of Medicine, United States of America.
Trauma Case Reports
|June 4, 2020
Summary
Chylothorax, a thoracic lymphatic trauma complication, lacks treatment guidelines. This study proposes a management guideline for blunt trauma chylothorax, differentiating low-output from high-output cases for prompt intervention.
Area of Science:
- Trauma Surgery
- Thoracic Medicine
- Critical Care Medicine
Background:
- Chylothorax is a serious complication of thoracic lymphatic trauma.
- Current management lacks standardized decision-making support for prompt treatment.
Observation:
- A case of a 53-year-old male with blunt thoracic trauma and chylothorax is presented.
- Initial non-operative management included a chest tube and a no-fat diet.
Findings:
- A proposed guideline for managing blunt trauma chylothorax in adults is developed based on a case review.
- Low-output chylothorax (<500 mL initial or daily output) can be managed non-operatively with high success rates.
- High-output chylothorax (>1000 mL initial output) warrants prompt surgical intervention.
Implications:
- This guideline aims to provide decision-making support for managing blunt traumatic chylothorax.
- Differentiating chylothorax output is crucial for selecting appropriate treatment strategies.
- Prompt and definitive care can improve outcomes for patients with traumatic chylothorax.
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