Conservative management of traumatic chylothorax: a case report

A case is presented of a right traumatic chylothorax, secondary to thoracic trauma with bilateral posterior eleventh rib fracture, treated by total parenteral nutrition and pleural drainage, with resolution within 2 weeks. On the basis of this clinical report and of a review of the literature, it is concluded that adequate conservative management should be initially the treatment of choice. Surgical treatment should be reserved to the cases in which clinical improvement does not occur within 2 weeks, and should consist of supradiaphragmatic thoracic duct ligation. Thoracoscopic fibrin glue injection has recently been described as a possible alternative treatment.