title: Delayed Chylothorax Following Blunt Chest Trauma.
abstract: Chylothorax is a very rare disease, and its diagnosis following blunt chest trauma is exceptional. Only a small number of cases have been reported in the literature. We report a case of a male patient involved in a car accident presenting a delayed chylothorax after blunt chest trauma with a bilateral serial rib fracture and fracture of the ninth thoracic vertebrae. The therapy includes thorax drainage, dietary modifications with total parenteral nutrition and, in severe cases, PEEP ventilation. Hematological monitoring is mandatory to detect metabolic abnormalities resulting from chyle loss. Surgical treatment is only required in cases of persistent or increasing intrathoracal chyle flow. Thoracoscopic ligation of the thoracic duct is then required.Severe consequences, such as cardiopulmonary abnormalities and metabolic, nutritional and immunologic disorders, can result from chylothorax. Our patient was treated successfully by chest drainage and parenteral nutrition.
authors.affiliation: Department of Trauma Surgery, Vienna Medical University, Vienna, Austria. mark.schurz@meduniwien.ac.at.|Department of General Surgery, General Hospital Oberpullendorf, Oberpullendorf, Austria. mark.schurz@meduniwien.ac.at.|Universitätsklinik für Unfallchirurgi, Vienna, Austria. mark.schurz@meduniwien.ac.at.|Universitätsklinik für Unfallchirurgie, Währinger Gürtel 18-20, 1090, Vienna, Austria. mark.schurz@meduniwien.ac.at.
authors.forename: Mark
authors.initials: M
authors.lastname: Schurz
authors.affiliation: Department of Trauma Surgery, Vienna Medical University, Vienna, Austria.
authors.forename: Nina
authors.initials: N
authors.lastname: Petras
authors.affiliation: Department of Trauma Surgery, Vienna Medical University, Vienna, Austria.
authors.forename: Patrick
authors.initials: P
authors.lastname: Platzer
authors.affiliation: Department of General Surgery, General Hospital Oberpullendorf, Oberpullendorf, Austria.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Hofbauer
authors.affiliation: Department of Trauma Surgery, Vienna Medical University, Vienna, Austria.
authors.forename: Vilmos
authors.initials: V
authors.lastname: Vécsei
keywords: Bilateral serial rib fracture; Blunt chest trauma; Chylothorax; Thoracovertebral fracture
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