Tuberculosis and Respiratory Diseases

  • 제72권1호
  • /
  • Pages.59-62
  • /
  • 2012
  • /
  • 1738-3536(pISSN)
  • /
  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
권호 표지
DOI QR코드

DOI QR Code

흉강삽관술 후 발생한 유미흉 1예

A Case of Chylothorax after Tube Thoracostomy

  • 최규언 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 강경훈 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 김성훈 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 서현웅 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 정복현 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 김성수 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 임재민 (울산대학교 의과대학 강릉아산병원 내과학교실)
  • Choi, Kyu-Un (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Kang, Gyung-Hoon (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Kim, Sung-Hoon (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Seo, Hyun-Woong (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Jung, Bock-Hyun (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Kim, Sung-Soo (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Lim, Jae-Min (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine)
  • 투고 : 2011.07.04
  • 심사 : 2011.08.24
  • 발행 : 2012.01.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Tube thoracostomy is known to cause complications such as bleeding or infection, but the incidence of chylothorax secondary to tube thoracostomy is under-reported, and therefore, we report this case. A patient was diagnosed as systemic lupus erythematosus with pleural and pericardial involvement. During repeated therapeutic thoracentesis, which were performed because of poor response to steroids and cylophosphamide, hemothorax developed and we therefore inserted a chest tube. The pleural effusion changed from red to milky color in several hours and we diagnosed the pleural effusion as chylothorax. Total parenteral nutrition based on medium-chain triglycerides was supplied to this patient and chylothorax was improved after 4 days.

키워드

참고문헌

  1. Lampson RS. Traumatic chylothorax; a review of the literature and report of a case treated by mediastinal ligation of the thoracic duct. J Thorac Surg 1948; 17:778-91.
  2. Staats BA, Ellefson RD, Budahn LL, Dines DE, Prakash UB, Offord K. The lipoprotein profile of chylous and nonchylous pleural effusions. Mayo Clin Proc 1980; 55:700-4.
  3. Hillerdal G. Effusions from lymphatic disruptions. In: Light RW, Lee YC, editors. Textbook of pleural diseases. 2nd ed. London: Hodder Arnold; 2008. p. 389-96.
  4. Murray JF, Jay AN, Mason RJ. Textbook of respiratory medicine. 5th ed. Philadelphia: Saunders; 2010.
  5. Kumar SP, Belik J. Chylothorax--a complication of chest tube placement in a neonate. Crit Care Med 1984; 12:411-2.
  6. Limsukon A, Yick D, Kamangar N. Chylothorax: a rare complication of tube thoracostomy. J Emerg Med 2011; 40:280-2.
  7. Rosenberger A, Abrams HL. Radiology of the thoracic duct. Am J Roentgenol Radium Ther Nucl Med 1971; 111:807-20.
  8. Doerr CH, Miller DL, Ryu JH. Chylothorax. Semin Respir Crit Care Med 2001;22:617-26.
  9. Hamm H, Pfalzer B, Fabel H. Lipoprotein analysis in a chyliform pleural effusion: implications for pathogenesis and diagnosis. Respiration 1991;58:294-300.
  10. Agrawal V, Sahn SA. Lipid pleural effusions. Am J Med Sci 2008;335:16-20.
  11. Maldonado F, Hawkins FJ, Daniels CE, Doerr CH, Decker PA, Ryu JH. Pleural fluid characteristics of chylothorax. Mayo Clin Proc 2009;84:129-33.
  12. Agrawal V, Doelken P, Sahn SA. Pleural fluid analysis in chylous pleural effusion. Chest 2008;133:1436-41.
  13. Lin YJ, Chen DY, Lan JL, Hsieh TY. Chylothorax as the initial presentation of systemic lupus erythematosus: a case report. Clin Rheumatol 2007;26:1373-4.
  14. Hashim SA, Roholt HB, Babavan VK, Vanitallie TB. Treatment of chyluria and chylothorax with mediuchain triglyceride. N Engl J Med 1964;270:756-61.
  15. Selle JG, Snyder WH 3rd, Schreiber JT. Chylothorax: indications for surgery. Ann Surg 1973;177:245-9.