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J Thorac Cardiovasc Surg 2006;131:752-753
© 2006 The American Association for Thoracic Surgery

Brief Communication

Thoracoscopic thoracic duct ligation for chylothorax after traumatic subclavian artery injury

Newton Roech Aerts, MD, Nilon Erling, Jr * , Paulo Roberto Ott Fontes, MD

Department of Vascular Surgery, Complexo Hospitalar Santa Casa de Porto Alegre Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Porto Alegre, Brazil.

Received for publication September 22, 2005; revisions received October 9, 2005; accepted for publication October 26, 2005.

* Address for reprints: Nilon Erling, Jr, Rua João Teles, n.280, apt.603, Bom Fim. Porto Alegre, RS—Brasil (Email: nilonjr@gmail.com).

The first 20% of the full text of this article appears below.

Blunt traumatic axillosubclavian vascular injury is an uncommon but challenging surgical problem. Because of the complex anatomic relationships in the upper mediastinum and thoracic outlet, associated injuries should always be investigated. Chylothorax after blunt chest trauma is a rare condition, 1 Go and no reports of its association with subclavian artery injury have been found in the literature. We report a case of successful thoracoscopic thoracic duct ligation to treat chylothorax after blunt trauma with vascular injury.

Clinical Summary

A 23-year-old man sustained trauma to the anterior chest wall in a car accident. On admission, he was neurologically intact but complained of pain in the left shoulder and arm. He was tachycardic and hypotensive. Chest radiography revealed left clavicle fracture and left hemothorax. A left chest tube was inserted, and 1200 mL was drained initially. Exploratory thoracotomy was performed through a median sternotomy. An injury was found in the left subclavian artery. Left supraclavicular extension was performed . . . [Full Text of this Article]






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