Atikun Limsukon1, Dennis Yick, Nader Kamangar. 1. Division of Pulmonary and Critical Care Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA. atikhun@hotmail.com
Abstract
BACKGROUND: Chylothorax resulting from chest tube injury to the thoracic duct is very rare and underreported. OBJECTIVE: The purpose of this case report is to exemplify this rare but potentially significant complication of chest tube thoracostomy. CASE REPORT: An 86-year-old woman presented with sepsis and a massive right pleural effusion; she developed a chylous effusion with the pleural fluid triglyceride level of 158 mg/dL 2 days after a traumatic chest tube insertion. All investigations excluded common causes of non-traumatic chylothorax. The chylothorax improved after fasting and implementation of a medium-chain triglyceride diet. CONCLUSION: The optimal depth of insertion of the chest tube typically ranges from 5 to 15 cm, ensuring all sideports are within the chest and the proximal port is at least 2 cm beyond the rib margin. Traumatic chylothorax secondary to chest tube insertion should be included in the differential diagnosis of patients presenting with chylothorax after a thoracostomy tube.
BACKGROUND: Chylothorax resulting from chest tube injury to the thoracic duct is very rare and underreported. OBJECTIVE: The purpose of this case report is to exemplify this rare but potentially significant complication of chest tube thoracostomy. CASE REPORT: An 86-year-old woman presented with sepsis and a massive right pleural effusion; she developed a chylous effusion with the pleural fluid triglyceride level of 158 mg/dL 2 days after a traumatic chest tube insertion. All investigations excluded common causes of non-traumatic chylothorax. The chylothorax improved after fasting and implementation of a medium-chain triglyceride diet. CONCLUSION: The optimal depth of insertion of the chest tube typically ranges from 5 to 15 cm, ensuring all sideports are within the chest and the proximal port is at least 2 cm beyond the rib margin. Traumatic chylothorax secondary to chest tube insertion should be included in the differential diagnosis of patients presenting with chylothorax after a thoracostomy tube.
Authors: Johnathon M Aho; Raaj K Ruparel; Phillip G Rowse; Rushin D Brahmbhatt; Donald Jenkins; Mariela Rivera Journal: World J Surg Date: 2015-11 Impact factor: 3.352
Authors: Michael Kwiatt; Abigail Tarbox; Mark J Seamon; Mamta Swaroop; James Cipolla; Charles Allen; Stacinoel Hallenbeck; H Tracy Davido; David E Lindsey; Vijay A Doraiswamy; Sagar Galwankar; David Tulman; Nicholas Latchana; Thomas J Papadimos; Charles H Cook; Stanislaw P Stawicki Journal: Int J Crit Illn Inj Sci Date: 2014-04