A Case of Chylothorax after Blunt Chest Trauma Accompanied by Nephrotic Syndrome

ABSTRACT

Chylothorax after blunt chest trauma is very rare and is generally caused by injuries to the thoracic duct or its major tributaries. Such an injury can cause a fistula, a localized collection of chyle known as a chyloma, or an intrapleural collection referred to as a chylothorax. We report a case of chylothorax attributed to thoracic duct injury after an in-car traffic accident, accompanied by nephrotic syndrome diagnosed after admission. An 11-year-old male was admitted because of dyspnea developed three days previously after an in-car traffic accident. He also complained of nausea, vomiting, and abdominal discomfort after meals. We took chest X-ray films and a chest CT scan in the emergency department, which showed pleural effusion on both sides and massive ascites. Diagnostic thoracentesis was then done, the aspirated fluid showed a milky-white appearance and fluid analysis showed chyle. Tube thoracostomy with fluid and nutritional support was administered but a week later the patient was more edematous and laboratory results revealed nephrotic features. After a further ten days, the patient was discharged with some symptomatic improvement, not confirmed by pathologic diagnosis.