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Chylothorax: A rare complication of tube thoracostomy

  • Author(s): Limsukon, A
  • Yick, D
  • Kamangar, N
  • et al.
Abstract

Background: Chylothorax resulting from chest tube injury to the thoracic duct is very rare and underreported. Objective: The purpose of this case report is to exemplify this rare but potentially significant complication of chest tube thoracostomy. Case Report: An 86-year-old woman presented with sepsis and a massive right pleural effusion; she developed a chylous effusion with the pleural fluid triglyceride level of 158 mg/dL 2 days after a traumatic chest tube insertion. All investigations excluded common causes of non-traumatic chylothorax. The chylothorax improved after fasting and implementation of a medium-chain triglyceride diet. Conclusion: The optimal depth of insertion of the chest tube typically ranges from 5 to 15 cm, ensuring all sideports are within the chest and the proximal port is at least 2 cm beyond the rib margin. Traumatic chylothorax secondary to chest tube insertion should be included in the differential diagnosis of patients presenting with chylothorax after a thoracostomy tube. © 2011 Elsevier Inc.

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