Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

TRAUMATIC CHYLOTHORAX

TRAUMATIC CHYLOTHORAX Abstract CHYLOTHORAX may be defined as the accumulation of chyle in the pleural cavity. According to Zesas,1 traumatic chylothorax was first described by Longelot in 1663, but it was not until 1875 that Quincke2 reported the first authoritative case. The rarity of this condition is brought out by the fact that there are very few cases in the literature. In 1938, Shackelford and Fisher3 reviewed the literature, discarded 11 cases mentioned too scantily to be included, summarized the remaining 39, and added two cases of their own. In 1947, Lampson4 reviewed and summarized 17 subsequent reports and added one of his own. We have found seven other cases not included in these two reviews and are adding one case of our own. (There is one case mentioned by Shackelford and Fisher3—Heppner's5—which is the same case cited by Lampson4 as Brown's6 References 1. Zesas, D. G.: Die nicht operativ entstandenen Verletzungen des Ductus thoracicus , Deutsche Ztschr. Chir. 115:49-62, 1912.Crossref 2. Quincke, H.: Chyluserguss in serosem hohlem Hydrops chylosus , Deutsche Arch. Klin. Med. 16:121, 1875. 3. Shackelford, R. T., and Fisher, A. M.: Traumatic Chylothorax , South. M. J. 31:766-775, 1938.Crossref 4. Lampson, R. S.: Traumatic Chylothorax , J. Thoracic Surg. 17:778-791, 1948. 5. Heppner, G. J.: Bilateral Chylothorax and Chyloperitoneum , J. A. M. A. 102:1294 ( (April 21) ) 1934.Crossref 6. Brown, A. L.: Traumatic Rupture of the Thoracic Duct with Bilateral Chylothorax and Chylous Ascites: New Operation; Report of Case , Arch. Surg. 34:120-124 ( (Jan.) ) 1937.Crossref 7. Buxton, C. L., and Morrison, D. E.: Gunshot Wound of the Thoracic Duct , U. S. Nav. M. Bull. 46:1899-1901, 1946. 8. Lee, F. C.: The Establishment of Collateral Circulation Following Ligation of the Thoracic Duct , Bull. Johns Hopkins Hosp. 33:21-31, 1922. 9. Blalock, A.; Cunningham, R. S., and Robinson, C. S.: Experimental Production of Chylothorax by Occlusion of the Superior Vena Cava , Ann. Surg. 104:359, 1936.Crossref 10. Van Pernis, P. A.: Variations of the Thoracic Duct , Surgery 26:806-809, 1949. 11. Gray, H.: Anatomy of the Human Body , ed. 25, Philadelphia, Lea & Febiger, 1948. 12. Acevedo, D.: Motor Control of the Thoracic Duct , Am. J. Physiol. 139:600-603, 1943. 13. Judd, E. S. Jr., and Nix, J. T.: Spontaneous and Traumatic Lymph Fistulas: Data on 40 Cases , S. Clin. North America 29:1035-1045, 1949. 14. Munk, I., and Rosenstein, A.: Zur Lehre von der Resorption im Darm, nach Untersuchungen und einer Lymph-(Chylus-)fistel beim Menschen , Arch. path. Anat. 123:484-518, 1891.Crossref 15. Drinker, C. K.: Extravascular Protein and Lymphatic System , Ann. New York Acad. Sc. 46:807-821, 1946.Crossref 16. Cellan-Jones, C. J., and Murphy, N.: Traumatic Chylothorax , Brit. M. J. 2:590-591, 1940.Crossref 17. Beck, C. S.: A Study of Lymph Pressure , Bull. Johns Hopkins Hosp. 35:206, 1924. 18. Drinker, C. K., and Yoffey, J. M.: Lymphatics, Lymph and Lymphoid Tissue: Their Physiological and Clinical Significance , Cambridge, Mass., Harvard University Press, 1941, pp. 406. 19. Straling, E. H.: The Influence of Mechanical Factors on Lymph Production , J. Physiol. 16:224-267, 1894. 20. (a) Crandall, L. A. Jr.; Barker, S. B., and Graham, D. G.: A Study of the Lymph Flow from a Patient with Thoracic Duct Fistula , Gastroenterology 1:1040-1048, 1943. 21. Maurer, F. W.: The Effects of Decreased Blood Oxygen and Increased Blood Carbon Dioxide on the Flow and Composition of Cervical and Cardiac Lymph , Am. J. Physiol. 131:331-348, 1940. 22. McCarrell, J. D., and Drinker, C. K.: Cervical Lymph Production During Histamine Shock in the Dog , Am. J. Physiol. 133:64-69, 1941. 23. Haynes, F. W.: Factors Which Influence the Flow and Protein Content of Subcutaneous Lymph in the Dog: I. Hemorrhage and Hyperemia , Am. J. Physiol. 101:223-231, 1932. 24. Polderman, H.; McCarrell, J. D., and Beecher, H. H.: Effect of Anesthesia on Lymph Flow , J. Pharmacol. & Exper. Therap. 78:400-406, 1943. 25. Nowak, S. J. G., and Barton, P. N.: Chylothorax: Report of Case Arrested by Phrenicotomy , J. Thoracic Surg. 10:628, 1941. 26. Gaudin, S.: Pathogenese und Klassifikation der milchartigen Ergüsse , Ergebn. inn. Med. u. Kinderh. 12:218, 1913. 27. Wallis, R. L., and Scholberg, H. A.: On Chylous and Pseudochylous Ascites , Quart. J. Med. 3:301, 1910. 28. Jahsman, W. E.: Chylothorax: Brief Review of Literature; Report of 3 Non-Traumatic Cases , Ann. Int. Med. 21:669-678, 1944. 29. Smith, D. D., and Woliver, E. M.: Traumatic Chylothorax , Arch. Surg. 43:627-632 ( (Oct.) ) 1941. 30. Hodge, G. B., and Bridges, H.: Surgical Management of Thoracic Duct Injuries , Surgery 24:805-810, 1948. 31. Dorsey, J. F., and Morris, G. E.: Traumatic Ruptures of the Thoracic Duct with Chylothorax , J. A. M. A. 119:337-338 ( (May 23) ) 1942. 32. (a) Whitcomb, B. B., and Scoville: Postoperative Chylothorax: Sudden Death Following Infusion of Aspirated Chyle , Arch. Surg. 45:747-753 ( (Nov.) ) 1942. 33. (b) Little, J. M.: Harrison, C., and Blalock. A.: Chylothorax and Chyloperitoneum , Surgery 11:392-401, 1942. 34. Ehrenhaft, J. L., and Meyers, R.: Blood Fat Levels Following Supradiaphragmatic Ligation of the Thoracic Duct , Ann. Surg. 128:38-45, 1948. 35. Cooper, A.: Three Instances of Obstruction of the Thoracic Duct with Some Experiments Showing the Effects of Tying That Vessel, Medical Records and Researches , London, 1798. 36. McNab, D. S., and Scarlett, E. P.: Traumatic Chylothorax , Canad. M. A. J. 27:29-36, 1932. 37. Baldridge, R. R., and Lewis, R. V.: Traumatic Chylothorax , Ann. Surg. 128:1056-1078, 1948. 38. Swift, E. A., and Neuhof, H.: Cervico-Mediastinal Lymphangioma with Chylothorax , J. Thoracic Surg. 15:173-181, 1946. 39. Paitre: Traumatic Rupture of Thoracic Duct with Left Chylothorax , Bull. et mém. Soc. nat. de chir. 55:813-816, 1929. 40. Strauss, A.: Chylothorax Due to Bullet Wound , J. Thoracic Surg. 5:539-551, 1936. 41. Beatty, O. A.: Chylothorax; Case Report , J. Thoracic Surg. 6:221, 1936. 42. Cushing, H.: Wounds of the Thoracic Duct , Ann. Surg. 27:719, 1898. 43. Florer, R., and Ochsner, A.: Traumatic Chylothorax , Surgery 17:622-629, 1945. 44. Hall, E. H., and Morgan: A Case of Chylous Ascites , Quart. Bull. Northwestern Univ. M. School 2:44, 1900. 45. (a) Bauersfeld, E. H.: Traumatic Chylothorax from Ruptured Thoracic Duct Treated by Intravenous Injection of Aspirated Chyle , J. A. M. A. 109:16-18 ( (May 22) ) 1937.Crossref 46. (b) Oeken; Ein Fall von Zerreissung des Ductus thoracicus infolge Brustquetschung , München. med. Wchnschr. 55:1182-1183, 1908. 47. Holt, L. E.; Tidwell, H. C., and Scott, T. F. McN.: Intravenous Administration of Fat , J. Pediat. 6:151, 1935.Crossref 48. Schnug, E., and Ransohoff, J.: Traumatic Chylothorax , Surgery 14:278-281, 1943. 49. Rienhoff, W. F. Jr.: Pneumonectomy , Bull. Johns Hopkins Hosp. 53:390-393, 1933. 50. Matson, R. C., and Stacy, J. W.: Traumatic Chylothorax , Dis. Chest 6:332-336, 1940.Crossref 51. Smithwick, cited by Baldridge and Lewis.36 52. Whiteside, W. C.; Stewart, W. D., and Cuthbertson, A. N.: Traumatic Chylothorax , Canad. M. A. J. 61:374-376, 1949. 53. Deansly, E.: A Case of Implantation of the Divided Thoracic Duct into the Internal Jugular Vein: Recovery , Lancet 2:1783, 1903.Crossref 54. Harrison, E. On the Treatment of Wounds of the Thoracic Duct , Brit. J. Surg. 4:304, 1916.Crossref 55. Shackelford and Fisher.3 Jahsman.28 Baldridge and Lewis.36 Lampson.4 56. Meade, R. H.: Personal communication to Lampson.4 57. Crafoord, C.: A Contribution to Thoracic Duct Surgery , Acta. chir. scandinav. 85:99-113, 1941. 58. Hinton, J. W., and Lord, J. W., Jr.: Operative Technique of Thoraco-Lumbar Sympathectomy , Surg., Gynec. & Obst. 83:643-646, 1946. 59. Shumacker, H. B., Jr., and Moore, T. C.: Surgical Management of Traumatic Chylothorax , Surg., Gynec. & Obst. 93:46-50, 1951. 60. Douady, D.; Dupuy, D., and Bouvrain, Y.: Chylothorax benin apres section d'adherences pleurales , Arch. med. chir. de l'opp. respir. 13:284-291, 1938. 61. Meade, R. H., Jr.; Head, J. R., and Moen, C. W.: The Management of Chylothorax , J. Thoracic Surg. 19:709-723, 1950. 62. Lowman, R. M.; Hoogerhyde, J.; Waters, L. L., and Grant, C.: Traumatic Chylothorax , Am. J. Roentgenol. 65:529-546, 1951. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Loading next page...
 
/lp/american-medical-association/traumatic-chylothorax-XJlWA54Btv
Publisher
American Medical Association
Copyright
Copyright © 1952 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1952.01260010265017
Publisher site
See Article on Publisher Site

Abstract

Abstract CHYLOTHORAX may be defined as the accumulation of chyle in the pleural cavity. According to Zesas,1 traumatic chylothorax was first described by Longelot in 1663, but it was not until 1875 that Quincke2 reported the first authoritative case. The rarity of this condition is brought out by the fact that there are very few cases in the literature. In 1938, Shackelford and Fisher3 reviewed the literature, discarded 11 cases mentioned too scantily to be included, summarized the remaining 39, and added two cases of their own. In 1947, Lampson4 reviewed and summarized 17 subsequent reports and added one of his own. We have found seven other cases not included in these two reviews and are adding one case of our own. (There is one case mentioned by Shackelford and Fisher3—Heppner's5—which is the same case cited by Lampson4 as Brown's6 References 1. Zesas, D. G.: Die nicht operativ entstandenen Verletzungen des Ductus thoracicus , Deutsche Ztschr. Chir. 115:49-62, 1912.Crossref 2. Quincke, H.: Chyluserguss in serosem hohlem Hydrops chylosus , Deutsche Arch. Klin. Med. 16:121, 1875. 3. Shackelford, R. T., and Fisher, A. M.: Traumatic Chylothorax , South. M. J. 31:766-775, 1938.Crossref 4. Lampson, R. S.: Traumatic Chylothorax , J. Thoracic Surg. 17:778-791, 1948. 5. Heppner, G. J.: Bilateral Chylothorax and Chyloperitoneum , J. A. M. A. 102:1294 ( (April 21) ) 1934.Crossref 6. Brown, A. L.: Traumatic Rupture of the Thoracic Duct with Bilateral Chylothorax and Chylous Ascites: New Operation; Report of Case , Arch. Surg. 34:120-124 ( (Jan.) ) 1937.Crossref 7. Buxton, C. L., and Morrison, D. E.: Gunshot Wound of the Thoracic Duct , U. S. Nav. M. Bull. 46:1899-1901, 1946. 8. Lee, F. C.: The Establishment of Collateral Circulation Following Ligation of the Thoracic Duct , Bull. Johns Hopkins Hosp. 33:21-31, 1922. 9. Blalock, A.; Cunningham, R. S., and Robinson, C. S.: Experimental Production of Chylothorax by Occlusion of the Superior Vena Cava , Ann. Surg. 104:359, 1936.Crossref 10. Van Pernis, P. A.: Variations of the Thoracic Duct , Surgery 26:806-809, 1949. 11. Gray, H.: Anatomy of the Human Body , ed. 25, Philadelphia, Lea & Febiger, 1948. 12. Acevedo, D.: Motor Control of the Thoracic Duct , Am. J. Physiol. 139:600-603, 1943. 13. Judd, E. S. Jr., and Nix, J. T.: Spontaneous and Traumatic Lymph Fistulas: Data on 40 Cases , S. Clin. North America 29:1035-1045, 1949. 14. Munk, I., and Rosenstein, A.: Zur Lehre von der Resorption im Darm, nach Untersuchungen und einer Lymph-(Chylus-)fistel beim Menschen , Arch. path. Anat. 123:484-518, 1891.Crossref 15. Drinker, C. K.: Extravascular Protein and Lymphatic System , Ann. New York Acad. Sc. 46:807-821, 1946.Crossref 16. Cellan-Jones, C. J., and Murphy, N.: Traumatic Chylothorax , Brit. M. J. 2:590-591, 1940.Crossref 17. Beck, C. S.: A Study of Lymph Pressure , Bull. Johns Hopkins Hosp. 35:206, 1924. 18. Drinker, C. K., and Yoffey, J. M.: Lymphatics, Lymph and Lymphoid Tissue: Their Physiological and Clinical Significance , Cambridge, Mass., Harvard University Press, 1941, pp. 406. 19. Straling, E. H.: The Influence of Mechanical Factors on Lymph Production , J. Physiol. 16:224-267, 1894. 20. (a) Crandall, L. A. Jr.; Barker, S. B., and Graham, D. G.: A Study of the Lymph Flow from a Patient with Thoracic Duct Fistula , Gastroenterology 1:1040-1048, 1943. 21. Maurer, F. W.: The Effects of Decreased Blood Oxygen and Increased Blood Carbon Dioxide on the Flow and Composition of Cervical and Cardiac Lymph , Am. J. Physiol. 131:331-348, 1940. 22. McCarrell, J. D., and Drinker, C. K.: Cervical Lymph Production During Histamine Shock in the Dog , Am. J. Physiol. 133:64-69, 1941. 23. Haynes, F. W.: Factors Which Influence the Flow and Protein Content of Subcutaneous Lymph in the Dog: I. Hemorrhage and Hyperemia , Am. J. Physiol. 101:223-231, 1932. 24. Polderman, H.; McCarrell, J. D., and Beecher, H. H.: Effect of Anesthesia on Lymph Flow , J. Pharmacol. & Exper. Therap. 78:400-406, 1943. 25. Nowak, S. J. G., and Barton, P. N.: Chylothorax: Report of Case Arrested by Phrenicotomy , J. Thoracic Surg. 10:628, 1941. 26. Gaudin, S.: Pathogenese und Klassifikation der milchartigen Ergüsse , Ergebn. inn. Med. u. Kinderh. 12:218, 1913. 27. Wallis, R. L., and Scholberg, H. A.: On Chylous and Pseudochylous Ascites , Quart. J. Med. 3:301, 1910. 28. Jahsman, W. E.: Chylothorax: Brief Review of Literature; Report of 3 Non-Traumatic Cases , Ann. Int. Med. 21:669-678, 1944. 29. Smith, D. D., and Woliver, E. M.: Traumatic Chylothorax , Arch. Surg. 43:627-632 ( (Oct.) ) 1941. 30. Hodge, G. B., and Bridges, H.: Surgical Management of Thoracic Duct Injuries , Surgery 24:805-810, 1948. 31. Dorsey, J. F., and Morris, G. E.: Traumatic Ruptures of the Thoracic Duct with Chylothorax , J. A. M. A. 119:337-338 ( (May 23) ) 1942. 32. (a) Whitcomb, B. B., and Scoville: Postoperative Chylothorax: Sudden Death Following Infusion of Aspirated Chyle , Arch. Surg. 45:747-753 ( (Nov.) ) 1942. 33. (b) Little, J. M.: Harrison, C., and Blalock. A.: Chylothorax and Chyloperitoneum , Surgery 11:392-401, 1942. 34. Ehrenhaft, J. L., and Meyers, R.: Blood Fat Levels Following Supradiaphragmatic Ligation of the Thoracic Duct , Ann. Surg. 128:38-45, 1948. 35. Cooper, A.: Three Instances of Obstruction of the Thoracic Duct with Some Experiments Showing the Effects of Tying That Vessel, Medical Records and Researches , London, 1798. 36. McNab, D. S., and Scarlett, E. P.: Traumatic Chylothorax , Canad. M. A. J. 27:29-36, 1932. 37. Baldridge, R. R., and Lewis, R. V.: Traumatic Chylothorax , Ann. Surg. 128:1056-1078, 1948. 38. Swift, E. A., and Neuhof, H.: Cervico-Mediastinal Lymphangioma with Chylothorax , J. Thoracic Surg. 15:173-181, 1946. 39. Paitre: Traumatic Rupture of Thoracic Duct with Left Chylothorax , Bull. et mém. Soc. nat. de chir. 55:813-816, 1929. 40. Strauss, A.: Chylothorax Due to Bullet Wound , J. Thoracic Surg. 5:539-551, 1936. 41. Beatty, O. A.: Chylothorax; Case Report , J. Thoracic Surg. 6:221, 1936. 42. Cushing, H.: Wounds of the Thoracic Duct , Ann. Surg. 27:719, 1898. 43. Florer, R., and Ochsner, A.: Traumatic Chylothorax , Surgery 17:622-629, 1945. 44. Hall, E. H., and Morgan: A Case of Chylous Ascites , Quart. Bull. Northwestern Univ. M. School 2:44, 1900. 45. (a) Bauersfeld, E. H.: Traumatic Chylothorax from Ruptured Thoracic Duct Treated by Intravenous Injection of Aspirated Chyle , J. A. M. A. 109:16-18 ( (May 22) ) 1937.Crossref 46. (b) Oeken; Ein Fall von Zerreissung des Ductus thoracicus infolge Brustquetschung , München. med. Wchnschr. 55:1182-1183, 1908. 47. Holt, L. E.; Tidwell, H. C., and Scott, T. F. McN.: Intravenous Administration of Fat , J. Pediat. 6:151, 1935.Crossref 48. Schnug, E., and Ransohoff, J.: Traumatic Chylothorax , Surgery 14:278-281, 1943. 49. Rienhoff, W. F. Jr.: Pneumonectomy , Bull. Johns Hopkins Hosp. 53:390-393, 1933. 50. Matson, R. C., and Stacy, J. W.: Traumatic Chylothorax , Dis. Chest 6:332-336, 1940.Crossref 51. Smithwick, cited by Baldridge and Lewis.36 52. Whiteside, W. C.; Stewart, W. D., and Cuthbertson, A. N.: Traumatic Chylothorax , Canad. M. A. J. 61:374-376, 1949. 53. Deansly, E.: A Case of Implantation of the Divided Thoracic Duct into the Internal Jugular Vein: Recovery , Lancet 2:1783, 1903.Crossref 54. Harrison, E. On the Treatment of Wounds of the Thoracic Duct , Brit. J. Surg. 4:304, 1916.Crossref 55. Shackelford and Fisher.3 Jahsman.28 Baldridge and Lewis.36 Lampson.4 56. Meade, R. H.: Personal communication to Lampson.4 57. Crafoord, C.: A Contribution to Thoracic Duct Surgery , Acta. chir. scandinav. 85:99-113, 1941. 58. Hinton, J. W., and Lord, J. W., Jr.: Operative Technique of Thoraco-Lumbar Sympathectomy , Surg., Gynec. & Obst. 83:643-646, 1946. 59. Shumacker, H. B., Jr., and Moore, T. C.: Surgical Management of Traumatic Chylothorax , Surg., Gynec. & Obst. 93:46-50, 1951. 60. Douady, D.; Dupuy, D., and Bouvrain, Y.: Chylothorax benin apres section d'adherences pleurales , Arch. med. chir. de l'opp. respir. 13:284-291, 1938. 61. Meade, R. H., Jr.; Head, J. R., and Moen, C. W.: The Management of Chylothorax , J. Thoracic Surg. 19:709-723, 1950. 62. Lowman, R. M.; Hoogerhyde, J.; Waters, L. L., and Grant, C.: Traumatic Chylothorax , Am. J. Roentgenol. 65:529-546, 1951.

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Feb 1, 1952

References

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$499/year

Save searches from
Google Scholar,
PubMed

Create folders to
organize your research

Export folders, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month