ABSTRACT

Chylothorax is defined as the accumulation of chyle in the pleural cavity. The non-iatrogenic traumatic etiology occurs in 0.2 to 3% of all cases. We introduce the case of an 18-year-old male who was admitted with history of aggression with a sharp-pointed instrument, which resulted in initial right anterolateral thoracotomy with pulmonary injury hemostasis and right posterior paravertebral diaphragmatic sinus rhaphy. During the PO period, the chest-tube developed high output of chyle-like fluid. The diagnosis was corroborated with cytochemical study demonstrating triglycerides 243 mg/dl. Conservative management was attempted with fasting and parenteral nutrition, but the output remained on 1,000 cm³ on the fifth post operatory day with imaging showing cavity and fluid accumulation despite these measures. Surgical management with pleurodesis was performed. The patient had an adequate evolution; on the five post operatory day the patient started oral nutrition without new chylothorax evidence, the chest-drainage was removed and the patient discharged on seven day.

KEYWORDS

Chylothorax, thoracic trauma, penetrating trauma.

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