Literature DB >> 28620562

Delayed Chyle Leak Following Anterior Cervical Spinal Surgery: A Case Report and Management Algorithm.

Kyle Mueller1, Hasan R Syed1, Jay W Rhee2, Mani N Nair1.   

Abstract

Injury to the thoracic duct during anterior cervical spine surgery is a rare occurrence. A delayed chyle leak following an elective anterior cervical spinal surgery has not been reported in the literature. We present a report of a 59-year-old female with multiple prior neck surgeries who underwent an anterior cervical corpectomy and fusion (ACCF). The patient developed a delayed thoracic duct injury on postoperative day (POD) one, as no injury was noted intraoperatively. She was managed with conservative care involving a low-fat diet along with octreotide which led to the resolution of her symptoms. We present this case report because of its unique presentation and to assist spine surgeons with initial management. Surgeons should have increased awareness when performing anterior cervical approaches to the lower cervical and upper thoracic levels from the left side.

Entities:  

Keywords:  anterior spine surgery; chyle leak; degenerative spine disorders; drain fluid amylase; octreotide; thoracic duct injury

Year:  2017        PMID: 28620562      PMCID: PMC5467770          DOI: 10.7759/cureus.1231

Source DB:  PubMed          Journal:  Cureus        ISSN: 2168-8184


  10 in total

Review 1.  Aetiology and management of chylothorax in adults.

Authors:  Sukumaran K Nair; Matus Petko; Martin P Hayward
Journal:  Eur J Cardiothorac Surg       Date:  2007-06-18       Impact factor: 4.191

2.  Thoracic duct variations may complicate the anterior spine procedures.

Authors:  Omer Akcali; Amac Kiray; Ipek Ergur; Suleyman Tetik; Emin Alici
Journal:  Eur Spine J       Date:  2006-03-17       Impact factor: 3.134

3.  Chylorrhea: a rare complication of thoracoscopic discectomy of the thoracolumbar junction. Case report.

Authors:  Amin Amini; Ronald I Apfelbaum; Meic H Schmidt
Journal:  J Neurosurg Spine       Date:  2007-06

Review 4.  Chylothorax: aetiology, diagnosis and therapeutic options.

Authors:  Emmet E McGrath; Zoe Blades; Paul B Anderson
Journal:  Respir Med       Date:  2009-09-18       Impact factor: 3.415

5.  Thoracic duct injury during anterior cervical discectomy: a rare complication. Case report.

Authors:  A K Hart; J H Greinwald; C I Shaffrey; G N Postma
Journal:  J Neurosurg       Date:  1998-01       Impact factor: 5.115

6.  Chyloretroperitoneum following anterior spinal surgery.

Authors:  Namath S Hussain; David Hanscom; Rod J Oskouian
Journal:  J Neurosurg Spine       Date:  2012-09-14

7.  Octreotide as a therapeutic option for management of chylothorax.

Authors:  Sulaiman A Al-Zubairy; Abdulrazaq S Al-Jazairi
Journal:  Ann Pharmacother       Date:  2003-05       Impact factor: 3.154

8.  Octreotide in the treatment of thoracic duct injuries.

Authors:  K M Markham; J L Glover; R J Welsh; R J Lucas; P J Bendick
Journal:  Am Surg       Date:  2000-12       Impact factor: 0.688

9.  Pleural fluid characteristics of chylothorax.

Authors:  Fabien Maldonado; Finn J Hawkins; Craig E Daniels; Clinton H Doerr; Paul A Decker; Jay H Ryu
Journal:  Mayo Clin Proc       Date:  2009-02       Impact factor: 7.616

10.  Administration of octreotide for management of postoperative high-flow chylothorax.

Authors:  Fabio Barili; Gianluca Polvani; Veli K Topkara; Luca Dainese; Maurizio Roberto; Emad Aljaber; Massimo Bettoni; Faisal H Cheema; Piero Trabattuni; Alessandro Parolapi; Rita Spirito; Paolo Biglioli
Journal:  Ann Vasc Surg       Date:  2007-01       Impact factor: 1.466

  10 in total
  1 in total

Review 1.  Chylous fistula: management of a rare complication following right anterior cervical spine approach.

Authors:  Federica Novegno; Pierluigi Granaroli; Luigi Ciccoritti; Pierpaolo Lunardi; Mario Francesco Fraioli
Journal:  Eur Spine J       Date:  2019-02-28       Impact factor: 3.134

  1 in total

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