title: A case of a traumatic chyle leak following an acute thoracic spine injury: successful resolution with strict dietary manipulation.
abstract: BACKGROUND
  Chylothorax is a rare form of pleural effusion that can be associated with both traumatic and non-traumatic causes. Thoracic duct ligation is often the treatment of choice in postsurgical patients; however the optimal treatment of this disease process after traumatic injury remains unclear 1. We present a rare case of a thoracic duct injury secondary to a blunt thoracic spine fracture and subluxation which was successfully treated non-operatively.
  
  
  METHODS
  A 51 year old male presented as a tier one trauma code due to an automobile versus bicycle collision. His examination and radiographic work-up revealed fractures and a subluxation at the third and fourth thoracic spine levels resulting in paraplegia. He also sustained bilateral hemothoraces secondary to multiple rib fractures. Drainage of the left hemothorax led to the diagnosis of a traumatic chylothorax. The thoracic spine fractures were addressed with surgical stabilization and the chylothorax was successfully treated with drainage and dietary manipulation.
  
  
  CONCLUSIONS
  This unusual and complex blunt thoracic duct injury required a multidisciplinary approach. Although the spine injury required surgical fixation, successful resolution of the chyle leak was achieved without surgical intervention.
authors: Department of Surgery, Division of Trauma and Surgical Critical Care, Kern Medical Center, Bakersfield, California.
authors: Andrea M
authors: AM
authors: Pakula
authors: Department of Nutrition and Dietary Services, Kern Medical Center, Bakersfield, California.
authors: Wendy
authors: W
authors: Phillips
authors: Department of Surgery, Division of Trauma and Surgical Critical Care, Kern Medical Center, Bakersfield, California.
authors: Ruby A
authors: RA
authors: Skinner