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Traumatic chylothorax: a case report.

A case of traumatic chylothorax following a motor vehicle accident is presented. This is a rare injury following thoracic trauma and is associated with a high mortality and morbidity. Mechanisms of injury to the thoracic duct are described. A management strategy is suggested, which initially entails a trial of conservative therapy of adequate drainage, total parenteral nutrition (TPN) and total gut rest. If significant chyle losses persist after 2 weeks, surgery is indicated, as immunological factors may complicate recovery. The recommended surgical technique is transthoracic duct ligation directly or at the hiatus.