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October 1941


Author Affiliations


Arch Surg. 1941;43(4):627-632. doi:10.1001/archsurg.1941.01210160088012

Traumatic chylothorax is a relatively rare condition. In a recent comprehensive review of the subject, Shackelford and Fisher1 were able to collect only 43 authentic cases. They not only emphasized the rarity of traumatic chylothorax but also stressed the difficulty both of making an early diagnosis and of treating this condition. The reported mortality is approximately 50 per cent in spite of the various methods of therapy.

The causation of chylothorax has been summarized by McNab and Scarlett2 as follows:

I. Trauma

a. Closed trauma

1. Without fracture of bone

2. Accompanied by fracture of ribs, clavicle or vertebrae

b. Operative wounds

1. Duct severed

2. One or more terminals severed

c. Gunshot or stab wounds

II. New growth or granuloma outside the duct: carcinoma, lymphosarcoma, tuberculous glands

III. Thrombosis of the left subclavian vein

IV. New growth within the duct

V. Perforating lymphangitis

VI. Aneurysm of the