Blunt trauma is the leading cause of death of children and adolescents in the United States. Potentially life-threatening injuries from blunt trauma to the chest must be identified and treated immediately. Clinician familiarity with the range of possible injuries assists in timely diagnosis and therapy. Chylothorax from injury to the thoracic duct is a rare consequence of blunt chest trauma. Tension chylothorax is exceptionally rare. We present a case of a 22-month old boy found to have a traumatic tension chylothorax during initial evaluation in the resuscitation bay after transfer from another facility. There have been no previous reports of a pediatric tension chylothorax after blunt trauma. Management consisted of drainage with tube thoracostomy, parenteral nutrition, and octreotide until the chyle leak resolved. Surgical ligation of the thoracic duct was not required. Highlights ? Review of the first reported tension chylothorax after blunt trauma in a child. ? Management principles for tension chylothorax. ? Review of injuries concerning for non-accidental trauma in children.
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