Traumatic Chylothorax due to Cervical Stab Wound: A Case Report

Marcelo A. F. Ribeiro Junior, G. Tebar, Rafael de Lima Silva, Thiago Gaspar, Vitor Hernandes Lopes, Vinicius Vertematti de Castro, Jose Mauro da Silva Rodrigues
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Abstract

Chylothorax corresponds to the incidence of chyle in the pleural space; it was described for the first time in 1633. Its most common cause is associated with iatrogenic injuries to the thoracic duct; 80% of them take place during surgeries, such as pneumonectomy or esophagectomy. A case of an unusual cervical stab wound complication in a 23-year-old man who presented a late large volume chylothorax has been presented and discussed in this paper, as well as its management. The presented case demonstrates a rare complication after a cervical stab wound. The management of chylothorax can involve non-operative management, non-operative intervention, or operative management depending on the symptoms and duration. Usually, surgical interventions are required after two weeks of clinical treatment. The differential diagnosis in a post-trauma acute onset ventilatory manifestation is mandatory to rule out pulmonary embolism. Traumatic chylothorax is a rare event; however, its morbidity and mortality rates can be catastrophic when it is not diagnosed early and when the treatment is not established based on a proper flowchart. Thus, dietary and drug-based clinical measures, interventional radiology, videothoracoscopy, and thoracotomy for thoracic duct ligation are valid therapeutic options for the proper management of these cases.
颈部刺伤致外伤性乳糜胸1例
乳糜胸对应于乳糜在胸膜间隙的发生率;它在1633年首次被描述。其最常见的原因与医源性胸导管损伤有关;其中80%发生在手术中,如全肺切除术或食管切除术。一个不寻常的颈部刺伤并发症在一个23岁的男人谁提出了晚期大容量乳糜胸已经提出和讨论,以及其管理。提出的情况下,显示一个罕见的并发症后,颈部刺伤。乳糜胸的治疗根据症状和持续时间可分为非手术治疗、非手术干预或手术治疗。通常,在临床治疗两周后需要进行手术干预。在创伤后急性发作通气表现的鉴别诊断是强制性的,以排除肺栓塞。外伤性乳糜胸是一种罕见的事件;然而,如果不及早诊断,如果不根据适当的流程确定治疗方法,其发病率和死亡率可能是灾难性的。因此,以饮食和药物为基础的临床措施、介入放射学、胸腔镜和开胸手术治疗胸导管结扎是治疗这些病例的有效选择。
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