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KMID : 0385920060170060659
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Journal of the Korean Society of Emergency Medicine
2006 Volume.17 No. 6 p.659 ~ p.663
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A Case of Chylothorax after Blunt Chest Trauma Accompanied by Nephrotic Syndrome
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Lee Sam-Beom
Lee Sung-Hoon
Kim Jung-Ho
Lee Jae-Young
Si Jong-Won
Do Byung-Soo
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Abstract
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Chylothorax after blunt chest trauma is very rare and is generally caused by injuries to the thoracic duct or its major tributaries. Such an injury can cause a fistula, a localized collection of chyle known as a chyloma, or an intrapleural collection referred to as a chylothorax. We report a case of chylothorax attributed to thoracic duct injury after an in-car traffic accident, accompanied by nephrotic syndrome diagnosed after admission. An 11-year-old male was admitted because of dyspnea developed three days previously after an in-car traffic accident. He also complained of nausea, vomiting, and abdominal discomfort after meals. We took chest X-ray films and a chest CT scan in the emergency department, which showed pleural effusion on both sides and massive ascites. Diagnostic thoracentesis was then done, the aspirated fluid showed a milky-white appearance and fluid analysis showed chyle. Tube thoracostomy with fluid and nutritional support was administered but a week later the patient was more edematous and laboratory results revealed nephrotic features. After a further ten days, the patient was discharged with some symptomatic improvement, not confirmed by pathologic diagnosis.
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KEYWORD
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Chylothorax, Blunt injury, Thoracic Duct, Nephrotic Syndrome
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