Late-Onset Chylothorax After Blunt Chest Trauma at an Interval of 20 Years: Report of a Case

摘要

We herein report an extremely rare case of a patient nchylothorax at an interval of 20 years after thoracic nvertebrae fractures, who underwent a successful thora-ncoscopic thoracic duct ligation and pleurodesis. A 51-nyear-old man was referred to our hospital with shortness nof breath on effort about 1 month after participating in narchery. Twenty years previously, he was involved in a ntraffi c accident. At that time, the patient sustained ntrauma to the spine and suffered a spinal injury, thus nresulting in paralysis in the lower part of his body. A nchest roentgenogram and computed tomogram revealed na large amount of bilateral pleural effusion. After tho-nracentesis was performed, a diagnosis of chylothorax nwas made and the patient was hospitalized. Conserva-ntive management by a low-fat diet proved to be unsuc-ncessful. The patient did not request pleurodesis, because npleural adhesions might impair pulmonary function. As na result, we decided to perform surgery. On the right nside, we performed video-assisted thoracoscopic surgery nby clipping the thoracic duct and applying an absorb-nable sealing material. Thereafter, pleurodesis was per-nformed and OK-432 was instilled. Thereafter, the pleural nfl uid fl ow was almost completely stopped. On the left nside, pleurodesis was effective. The patient has since nremained symptom free and has been followed up on nan outpatient basis for 9 months after the 100th post-noperative day. We assumed that the chylothorax in this ncase was related to the earlier traffi c accident.