Bilateral traumatic chylothorax: a complication of fracture-dislocation of the T-spine.

ABSTRACT

Traumatic chylothorax is a rare complication of fracture-dislocation of the thoracic spine. Not treated adequately, it will be associated with high mortality and morbidity. A review of the English literature shows that bilateral traumatic chylothorax is rarely discussed. A case is presented of fracture-dislocation of the third thoracic vertebra combined with bilateral traumatic chylothorax following a motor vehicle accident. The mechanism of injury is described. The management strategies are, initially, conservative treatment including chest tube drainage, NPO with total parenteral nutrition (TPN), followed by medium-chain triglyceride diet. Without improvement, surgical measures such as mediastinal ligation of the thoracic duct should be considered.