Traumatic chylothorax in a young child: Case report and management.

Autor:	Jahn HK; Paediatric Emergency Medicine, Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland, United Kingdom, Friedrich-Schiller-Universität Jena, Jena, Germany., Frost JH; Oxford University Hospitals NHS Trust, Oxford, England, United Kingdom., van As ABS; Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa.
Jazyk:	angličtina
Zdroj:	African journal of emergency medicine : Revue africaine de la medecine d'urgence [Afr J Emerg Med] 2017 Jun; Vol. 7 (2), pp. 84-86. Date of Electronic Publication: 2017 Apr 20.
DOI:	10.1016/j.afjem.2017.04.007
Abstrakt:	Introduction: A chylothorax is an uncommon feature of paediatric chest trauma. Case Report: We report a case of traumatic chylothorax following blunt chest trauma in an eight year-old girl with polytrauma after being hit by a motor vehicle. She was initially found to have a bilateral frontal skull fracture extending into the left parietal area, pulmonary contusions, left posterior rib fractures, left clavicular fracture and a degloving injury of her left foot. On the fifth day of her admission she developed progressive dyspnoea with signs of a pleural effusion, which was confirmed radiologically and drained by tube thoracostomy. Biochemical analysis confirmed chylothorax, which was managed conservatively with a fat free diet. The chest tube was removed after it stopped draining over 20 mL per 12 hours and she made a full recovery. Discussion: Initial management of chylothorax is conservative with tube thoracostomy drainage and fat free diet. Traumatic chylothroax is a rare complication following chest trauma and can take days to develop and to become clinically apparent. It is therefore important to be vigilant for potential late complications in blunt chest trauma in children, especially if there are extensive rib fractures, a sign of major transmission of force to the thorax.
Databáze:	MEDLINE
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