Carrillo-Esper R, Sosa-García JO, Carrillo-Córdova CA

Language: Spanish
References: 19
Page: 479-482
PDF size: 89.42 Kb.

ABSTRACT

Background: Chylothorax is the occurrence of chylo in the pleural space due to damage or obstruction of the thoracic duct. Its etiology can be traumatic or nontraumatic. Traumatic lesion of the thoracic duct occurs after accidents or cardiothoracic surgery. Non-Hodgkin’s lymphoma is the most frequent nontraumatic etiology. Milky aspect and high content of triglycerides in pleural fluid confirm the diagnosis. The objective of this paper is to present a case of chylothorax secondary to shotgun lesion as well as to review current concepts about chylothorax and its treatment. Clinical case: We present the case of a 33-year-old male patient with chylothorax secondary to gunshot lesion. Management was based on fasting, parenteral nutrition and pleural drainage. Patient’s evolution was satisfactory. Conclusions: Chylothorax is an entity associated with high morbidity and mortality. Early diagnosis and appropriate treatment are essential.

REFERENCES

1. Doerr CH, Miller DL, Ryu JH. Chylothorax. Semin Resp Crit Care Med 2001;22:617-626.

2. 2.Valentine VG, Raffin TA. The management of chylothorax. Chest 1992;102:586-591.

3. Ikonomidis JS, Boulanger BR, Brenneman FD. Chylothorax after blunt chest trauma: a report of 2 cases. Can J Surg 1997;40:135-138.

4. López F, Iribarren JL, Martínez C, Fernández R, Lacruz A, Quesada A. Quilotórax secundario a traumatismo torácico cerrado. Arch Bronconeumol 1997;33:168-171.

5. Doerr CH, Allen MS, Nichols FC, Ryu JH. Etiology of chylothorax in 203 patients. Mayo Clin Proc 2005;80:867-870.

6. Chan S, Lau W, Wrong W. Quilothorax in children after congenital heart surgery. Ann Thorax Surg 2006;82:1650-1657.

7. Silen ML, Weber TR. Management of thoracic duct injury associated with fracture dislocation of the spine following blunt trauma. J Trauma 1995;39:1185-1187.

8. Milano S, Maroldi R, Vezzoli G, Bozzola G, Battaglia G, Mombelloni G. Chylothorax after blunt chest trauma: an unusual case with a long latent period. Thorax Cardiovasc Surg 1994;42:187-190.

9. 9.Staats BA, Ellefson RD, Budahn LL, Dines DE, Prakash UB, Offord K. The lipoprotein profile of chylous and nonchylous pleural effusions. Mayo Clin Proc 1980;55:700-704.

10. Merrigan BA, Winter DC, O’Sullivan GC. Chylothorax. Br J Surg 1997;84:1520.

11. Chinnock BF. Chylothorax: case report and review of the literature. J Emerg Med 2003;24:259-262.

12. McCormick J, Henderson SO. Blunt trauma-induced bilateral chylothorax. Am J Emerg Med 1999;17:302-304.

13. Jensen GL, Mascioli EA, Meyer LP, Lopes SM, Bell SJ, Babayan VK et al. Dietary modification of chyle composition in chylothorax. Gastroenterology 1989;97:761-765.

14. Buettiker V, Hug MI, Burger R, Baenziger O. Somatostatin: a new therapeutic option for the treatment of chylothorax. Intensive Care Med 2001;27:1083-1086.

15. Markham KM, Glover JL, Welsh RJ, Lucas RJ, Bendick PJ. Octreotide in the treatment of thoracic duct injuries. Am Surg 2000;66:1165-1167.

16. Al-Zubairy SA, Al-Jazairi AS. Octreotide as a therapeutic option for management of chylothorax. Ann Pharmacother 2003;37:679-682.

17. 17.Ziedalski TM, Raffin TA, Sze DY, Mitchell JD, Robbins RC, Theodore J, et al. Chylothorax after heart/lung transplantation. J Heart Lung Transpl 2004;23:627-631.

18. Chamberlain M, Ratnatunga C. Late presentation of tension chylothorax following blunt chest trauma. Eur J Cardiothorac Surg 2000;18:357-359.

19. Buchan KG, Hosseinpour AR, Ritchie AJ. Thoracoscopic thoracic duct ligation for traumatic chylothorax. Ann Thorac Surg 2001;72:1366-1367.