Massive bilateral chylothorax post blunt trauma

Kozul, Christina; Jassal, Karishma; Judson, Rodney

doi:10.1016/j.tcr.2017.10.024

Cited by 4 publications

(5 citation statements)

References 10 publications

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“…One patient underwent both thoracotomy and laparotomy. Those patients underwent operation (both thoracotomy and thoracoscopy) had drainage more than 800 cc/days for several days [3,8,9]. Table 1 shows relevant data regarding chylothorax caused by blunt chest trauma.…”

Section: Resultsmentioning

confidence: 99%

“…In the current metadata, conservative treatment succeeded in 71.4% of the cases. [1,4,6,7,9,16,17,[19][20][21][22][23][24]. Routine conservative management is not recommended as it yields 50% mortality rate; this decreased to 10% with classical surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

“…In 22.8% of the cases, classical posterolateral thoracotomy was performed and in two cases, surgical ligation was done by thoracoscopy [5,9]. Sokouti and Aghdam reported a 15-yearold male with a history of blunt chest trauma before 11 years; thoracotomy and ligation of thoracic duct failed to control the condition.…”

Section: Discussionmentioning

confidence: 99%

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Chylothorax caused by blunt chest trauma: a review of literature

Kakamad

Salih

Mohammed

et al. 2020

Indian J Thorac Cardiovasc Surg

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Chylothorax is the accumulation of chyle in the pleural cavity that typically contains a high concentration of triglycerides. Blunt chest trauma is a rare cause. The aim of this study is to review all of the reported cases of chylothorax caused by blunt chest trauma. Available databases were explored systematically for the condition and the eligible papers were included. The literature search revealed 30 studies with 39 cases, 72.3% of the cases were male, and 21.7% of the patients were female. The age range varied between 4 and 75 years with a mean age of 35.8 years. All of the patients were diagnosed after fluid sampling from the pleural fluid by thoracentesis and/or chest tube insertion. About 71.4% of the patients were treated successfully by conservative management: others (28.6%) were managed surgically. Although it is a rare condition, persistent milky drainage after blunt chest trauma should raise the suspicion of chylothorax. Pleural fluid sampling is the cornerstone of the diagnosis. In the majority of the cases, conservative treatment is quite enough. Surgery is indicated whenever non-operative measures failed.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Chylothorax caused by blunt chest trauma: a review of literature

Kakamad

Salih

Mohammed

et al. 2020

Indian J Thorac Cardiovasc Surg

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“…It is understandable how an isolated thoracic duct injury can occur following penetrating trauma and there are numerous cases reported in the literature describing this event [10][11][12]. Many cases of thoracic duct injury following blunt force trauma do not happen in isolation, often these cases also involve fractures within the thorax [13][14][15][16][17][18][19][20][21]. These fractures may be associated with direct trauma to the thoracic duct leading to a tear in the lymphatics.…”

Section: Etiology and Demographicsmentioning

confidence: 99%

Isolated thoracic duct injury from blunt force trauma

2020

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Isolated thoracic duct injury is an uncommon clinical event and is rare in the setting of trauma. We describe a case of an isolated thoracic duct injury resulting in the development of bilateral chylothorax following a motor vehicle collision in the absence of any other definable injury. We outline the initial patient presentation and diagnosis. After failing a trial of conservative management the patient underwent lymphangiography followed by thoracic duct ligation with pleurodesis. This case highlights the importance of recognizing thoracic duct injury following trauma.

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“…For example, the most common operation performed by MSF is cesarean section [3, 5] and most HIC general surgeons do not learn this procedure during their training. Also, pathologies in HICs may differ: 80% of HIC abdominal trauma is blunt, caused by road traffic accidents, and utilize non‐operative management [6, 7], whereas in the humanitarian setting, traumatic abdominal trauma is usually penetrating, caused by intentional or unintentional injury especially in armed conflict settings, and requires surgery [8, 9]. In a recent publication, Lin and colleagues demonstrated that US general surgery residency did not provide the technical competency to work in humanitarian crises.…”

Section: Introductionmentioning

confidence: 99%

South African General Surgeon Preparedness for Humanitarian Disasters

et al. 2018

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Background Humanitarian medical organizations provide surgical care for a broad range of conditions including general surgical (GS), obstetric and gynecologic (OBGYN), orthopedic (ORTHO), and urologic (URO) conditions in unstable contexts. The most common humanitarian operation is cesarean section. The objective of this study was to identify the proportion of South African general surgeons who had operative experience and current competency in GS, OBGYN, ORTHO, and URO humanitarian operations in order to evaluate their potential for working in humanitarian disasters. Methods This was a cross-sectional online survey of South African general surgeons administered from November 2017-July 2018. Rotations in OBGYN, ORTHO, and URO were quantified. Experience and competency in eighteen humanitarian operations were queried. Results There were 154 SA general surgeon participants. Prior to starting general surgery (GS) residency, 129 (83%) had OBGYN, 125 (81%) ORTHO, and 84 (54%) URO experience. Experience and competency in humanitarian procedures by specialty included: 96% experience and 95% competency for GS, 71% experience and 51% competency for OBGYN, 77% experience and 66% competency for ORTHO, and 86% experience and 81% competency for URO. 82% reported training, and 51% competency in cesarean section. Conclusions SA general surgeons are potentially well suited for humanitarian surgery. This study has shown that most SA general surgeons received training in OBGYN, ORTHO, and URO prior to residency and many maintain competence in the corresponding humanitarian operations. Other low-to middle-income countries may also have broad-based surgery training, and the potential for their surgeons to offer humanitarian assistance should be further investigated.

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Massive bilateral chylothorax post blunt trauma

Cited by 4 publications

References 10 publications

Chylothorax caused by blunt chest trauma: a review of literature

Chylothorax caused by blunt chest trauma: a review of literature

Isolated thoracic duct injury from blunt force trauma

South African General Surgeon Preparedness for Humanitarian Disasters

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