Late Occurrence of Traumatic Chylothorax in a Multi-Trauma Patient With a Thoracic Spine Fracture-Dislocation

Abstract

Chylothorax is a rare form of chyle accumulation that can be associated with both traumatic and non-traumatic causes. We described a case of a patient who sustained a thoracic spine fracture-dislocation and presented with a left-sided chylothorax as a late complication to his thoracic spine trauma. A 19-year-old multi-trauma patient with bilateral pneumothorax, bilateral lung contusions and a severe thoracic spine fracture-dislocation was admitted to the intensive care unit (ICU) of our hospital intubated due to his unstable respiratory function. Bilateral thoracostomies were placed to his thoracic cavity prior to his admission to the ICU. The thoracic fracture-dislocation was stabilized with posterior fixation of his thoracic spine during his stay at the ICU. He was transferred to the neurosurgery department where at the 50th day of his hospitalization, a left-sided chylothorax was identified. Conservative management was decided and the chyle leak ceased over a period of 2 weeks. The patient was discharged from the clinic after a 3-month period of hospitalization. Traumatic chylothorax is a rare complication directly linked to thoracic spine fractures. It can occur immediately after trauma or several weeks after as in our case. Early diagnosis and treatment are essential for the avoidance of severe complications linked to the chyle loss.

Late-onset tension traumatic chylothorax: A case report and literature review

“…Late-onset can occur anywhere, from 5 days, 2 weeks, to a couple of months. There is even a case of onset after 20 years after a thoracic vertebral fracture in a patient with multiple injuries [6][7][8][9] . In these extraordinary situations, we ought to consider that the early clinical identification of the etiology is fundamental to defining and beginning management.…”