Unusual airway obstruction due to thoracic duct injury after whiplash injury [Ulus Travma Acil Cerrahi Derg]
Ulus Travma Acil Cerrahi Derg. Ahead of Print: UTD-08055 | DOI: 10.14744/tjtes.2020.08055  

Unusual airway obstruction due to thoracic duct injury after whiplash injury

Dae Sung Ma1, Sung Wook Chang1, Dong Hun Kim2
1Trauma Center, Department Of Thoracic And Cardiovascular Surgery, Dankook University Hospital, Cheonan, Republic Of Korea
2Trauma Center, Department Of Surgery, Dankook University Hospital, Cheonan, Republic Of Korea

Traumatic chylothorax is a rare condition following blunt trauma. Although a chyle leak resulting from direct damage to the duct may occur at any level because of an anatomical variation, an airway obstruction due to thoracic duct injury after blunt trauma has never been described. Here, we report a very unusual case with an airway obstruction due to thoracic duct injury after whiplash injury. A 60-year-old man presented to the emergency department with allodynia after blunt trauma. Initial chest computed tomography (CT) showed a prevertebral hematoma and pneumomediastinum from C2 to T3 spinal level without vertebral fracture. Seven days later, repeat CT showed an increased amount of mediastinal and prevertebral fluid collection extending to upper neck level with compression of the airway. He underwent an operation to drain the fluid via a neck incision and a thoracic duct ligation via right thoracotomy and was discharged without complaint. If hematoma and pneumomediastinum are found in the prevertebral space at the level of the cervical and upper thoracic spine, the patient should be closely observed to exclude the complication of airway obstruction caused by thoracic duct injury.

Keywords: airway obstruction, chylothorax, injuries, thoracic duct, trauma




Corresponding Author: Sung Wook Chang, South Korea


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