Management of Cervical Thoracic Duct Injury and Chyle Leak; Tertiary Center Results

Document Type : Original Article

Authors

1 Department of Otolaryngology, Faculty of Medicine, Ain Shams University, Egypt

2 Department of General Surgery, Faculty of Medicine for Girls, Al Azhar University, Egypt

Abstract

Introdution: Thoracic duct injury is rare but serious incident that is mostly associated with thorasic and neck
surgery rather than nonsurgical trauma. Generally, chylothorax requires prompt medical attention after diagnosis
in order to prevent serious consequences or mortality.
Patient and methods: This is a retrospective study on patients who presented by chyle leek in Ain Shams
University hospitals dutring the last 10 years in our tertiary center.
Results: 19 patients presented with chyle leak. 4 patients were discovered intraoperative (and those were the
only cases repaired primarly). 8 presented on the first postoperative day. And 5, 2 cases presented on the second
and third day respectively. About output flow 4 case had high output flow and 13 had low output flow, while two
cases had no flow following primary intraoperative repair. Conservative management by diet control, pressure
application and orlistat use were applied in all cases. Octreotide use was needed in 10 cases for a period ranging
from 3-12 days. In resistant cases Sclerotherapy was needed in two cases and re-exploration was needed in three
cases.
Conclusion: In all cases of chyle leek conservative management should be tried especially in low output flow.
Surgical re exploration should be used in resistant cases. Any case discovered intraoperatively should be primarily
explored and ligated.

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Ain Shams Journal of Surgery
Volume 18, Issue 1
January 2025
Pages 27-31

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