Injuries of ductus thoracicus

Keywords: trauma of ductus thoracicus; chylothorax; treatment.

Abstract

Objective. To study peculiarities of course and diagnosis of traumatic and spontaneous injuries of ductus thoracicus.

Маterials and methods. Ten patients, suffering chylothorax, were observed and examined, using thoracoscopy, аnd exudate - using test with sudan ІІІ.

Results. In 6 patients the injuries of ductus thoracicus were revealed: in 1 patient - direct, in 1 - iatrogenic, and in 4 - spontaneous. In 4 patients chylothorax presented a symptom of other diseases.

Conclusion. Diagnostic-treatment tactics, if the ductus thoracic injury and presence of chylothorax are suspected, ought to be following: analysis of anamnesis - pleural puncture - exudate aspiration - investigation, directed on identification of the malignant tumor cells and mycobacteria of tuberculosis - test with sudan ІІІ - thoracoscopy - pleurobiopsy - histological investigation - final diagnosis - specialized treatment (оperative-conservative).

Author Biographies

І. D. Duzhyi, Меdical Institute of Sumy State University

Duzhyi Igor, MD, DSci, Professor,
Head of the Department of Surgery, traumatology, orthopedics and phthisiology
Sumy State University, Ukraine.
48 Troitska str., 40000, Sumy, Ukraine
+380990081259
gensurgery@med.sumdu.edu.ua
orcid.org/0000-0002-4995-0096

O. M. Lytvynenko, Меdical Institute of Sumy State University

Lytvynenko Oleksandr M., MD, DSci(Med)
Professor of the Department of Surgery, traumatology, orthopedics and phthisiology
Sumy State University, Ukraine.
48 Troitska str., 40000, Sumy, Ukraine
omlytvynenko@gmail.com
orcid.org/0000-0003-0806-5047

S. О. Holubnichyi, Меdical Institute of Sumy State University

Holubnichyi Stanislav, MD, PhD. Assistant Professor
Department of Surgery, traumatology, orthopedics and phthisiology.
Sumy State University, Ukraine.
48 Troitska str., 4000, Sumy, Ukraine,
+380509265854,
s.holubnychyi@med.sumdu.edu.ua
https://orcid.org/0000-0002-4965-011

О. L. Sytnik, Меdical Institute of Sumy State University

Sytnik Oleksandr, PhD, Associate Professor,
Department of surgery, traumatology, orthopedics, phthisiology,
Sumy State University, Ukraine.
2 M. Vovchok str., 40007, Sumy, Ukraine
+380509380146
a.sytnik@med.sumdu.edu.ua
https://orcid.org/0000-0001-6855-2467

V. Ya. Pak, Меdical Institute of Sumy State University

Pak Vasyl, MD, PhD, Associate Professor
Department of surgery, traumatology, orthopedics, phthisiology,
Sumy State University, Ukraine.
2 M. Vovchok str., 40007, Sumy, Ukraine
+380501306399
v.pak@med.sumdu.edu.ua
https://orcid.org/0000-0002-2124-320X

І. А. Symonenko, Меdical Institute of Sumy State University

Symonenko Iryna, student
Medical Institute, Sumy State University, Ukraine.
1/53 Zalivnaya str, 40035, Sumy, Ukraine
+380959302918
irina_simonenko@i.ua
https://orcid.org/0000-0002-6518-7465

References

Beghetti M, La Scala G, Belli D, Bugmann P, Kalangos A, Le Coultre C. Etiology and management of pediatric chylothorax. J Pediatr. 2000 May;136(5):653-8. doi: 10.1067/mpd.2000.104287. PMID: 10802499.

McGrath EE, Blades Z, Anderson PB. Chylothorax: aetiology, diagnosis and therapeutic options. Respir Med. 2010 Jan;104(1):1-8. doi: 10.1016/j.rmed.2009.08.010. Epub 2009 Sep 18. PMID: 19766473.

Bockeria LA, Abalmasov КС, Morozov КМ, Puzenko DV, Belov SV. Thoracic lymphatic duct injury. Annaly khirurgii. 2007;(2): 17-21. [In Russian].

de Beer HG, Mol MJ, Janssen JP. Chylothorax. Neth J Med. 2000 Jan;56(1):25-31. doi: 10.1016/s0300-2977(99)00114-x. PMID: 10667039.

Belov YuV, Milanov NO, Stepanenko AB, Gasanov AF. Chylothorax in thoracic surgery. Pirogov Russian Journal of Surgery. 2012; (10): 61. [In Russian].

Shilenko PA, Tsoi MD, Pavlov AA, Fomenko MS, Osmerkina MN, Kotov SN, et al. Thoracoscopic treatment of chylothorax after coronary artery bypass grafting. Russ Jour Card and Cardiovasc Surg. 2019;12(2):164-7. [In Russian]. doi: 10.17116/ kardio201912021164.

Kondrashkina EV. Solodovnik AS. A clinical case of conservative management of a patient with chylothorax. In: Actual problems of theoretical, experimental, clinical medicine and pharmacy. Tyumen: RITs «Ayveks»; 2018. 317-8. [In Russian].

Shapkin AA, Efimenko IV. Chylothorax in surgical practice: diagnosis and treatment. Fundamentalnaya i klinicheskaya meditsina. 2016;1(1):69-72. [In Russian].

Parshin VD. Chylothorax in practice of thoracic and cardiovascular surgeon. Surgery. 2016;(7):36-44. [In Russian]. doi: 10.17116/hirurgia2016736-44.

Parshin VD, Vyzhigina MA, Bunyatyan AA, Parshin AV, Zhukova SG. Treatment of chylothorax - anesthesiological or surgical problem? Russian Journal of Anaesthesiology and Reanimatology. 2017;62(1):63-8. [In Russian]. doi: 10.18821/0201-7563-2017-62-1-63-68

Kasyanova NYu, Arakelyan VS, Malinin AA, Gidaspov NA, Bockeria LA. Drug treatment of chylothorax. Physiological aspects. Klinicheskaya fiziologiya krovoobrashcheniya. 2016; 13(2): 85-92. [In Russian]

Zabeck H, Muley T, Dienemann H, Hoffmann H. Management of chylothorax in adults: when is surgery indicated? Thorac. Cardiovasc Surg. 2011; 59 (4): 243-6. doi: 10.1055/s-0030-1250374

Lagarde S.M., Omloo J.M., de Jong K. et al. Incidence and management of chyle leakage after esophagectomy. Ann. Thorac. Surg. 2005; 80: 449-54. doi: 10.1016/j.athoracsur.2005.02.076.

Published
2020-09-30
How to Cite
DuzhyiІ. D., Lytvynenko, O. M., HolubnichyiS. О., SytnikО. L., Pak, V. Y., & SymonenkoІ. А. (2020). Injuries of ductus thoracicus. Klinicheskaia Khirurgiia, 87(7-8), 20-24. https://doi.org/10.26779/2522-1396.2020.7-8.20
Section
General Problems of Surgery