Traumatic contralateral chylothorax in a patient with penetrating neck injury: a case report

Abstract

Chylothorax is defined as a collection of chyle within the pleural cavity secondary to injury of the thoracic duct. We describe a rare case of a contralateral chylothorax resulting from a penetrating wound to the left lower anterior neck region. A 37-year-old male presented to the emergency room with a penetrating stab wound of the left neck. Upon clinical exam, the wound measured about 3–4 cm with minimal bleeding and no expanding hematoma or other hard sign of vascular injury. Subsequently, his right chest tube output developed a milky appearance with a total volume of 260 cc over 24 h. The specimen was sent for triglyceride analysis and confirmed diagnosis of chylothorax. He was managed with conservative therapy not requiring surgical intervention. The anatomical variations arising in the thoracic duct warrant the consideration of possible chylothorax in both right and left pleural effusions secondary to penetrating trauma.

A Penetrating Neck Injury Resulting in the Complete Transection of the Ipsilateral Common Carotid Artery, Delayed Contralateral Pneumothorax, and Occult Esophageal Injury: A Case Report With a Multidisciplinary Approach to Management

“…Olutu et al presented a case of a penetrating left neck injury leading to a right pneumothorax. Bronchoscopy and EGD were negative for airway or esophageal injury, though that patient did develop a chylothorax, which resolved by day 10 [ 7 ]. Another related case from Sharma et al discussed a right supraclavicular stabbing, with CT showing air extending from the entry site retrosternal to the left hemithorax.…”