Abstract
A 66-year-old woman was admitted to the department of Orthopedic Surgery of our hospital in June 2007 for treatment of a comminuted fracture of the left lower leg, compressed fracture of a lumbar vertebra and bilateral rib fracture, she had suffered in a traffic accident. She complained of respiratory discomfort and a chest CT taken on posttraumatic day 1 showed massive left pleural effusion. A chest drain was inserted and bloody pleural effusion was discharged. On posttraumatic day 2 the drainage fluid turned clouded white after she drank milk. The concentration of triglycerides in the drainage fluid was 333mg/dl and higher than in serum (107mg/dl). An enhanced CT revealed compression of the left subclavian artery at the level of the left first rib fracture. The condition was diagnosed as traumatic chylothorax due to thoracic duct injury. She was administered octreotide acetate at the dose of 150μg/body/day by subcutaneous injection for 5 days under fasting treatment. The drainage fluid turned clear and yellowish on posttraumatic day 5. The chest drainage was removed on posttraumatic day 10. To the best of our knowledge, this is the first case of a chylothorax caused by blunt trauma successfully treated with octreotide acetate reported in Japan.
