日本口腔外科学会雑誌
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
症例報告
頸部郭清術後に生じた両側乳糜胸の1例
池田 篤司水谷 雅英山本 祐也有村 友紀植村 亜由美飯田 征二
著者情報
キーワード: 乳糜胸, 乳糜, 頸部郭清術, 胸管
ジャーナル フリー

2015 年 61 巻 5 号 p. 288-292

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Bilateral chylothorax is a rare complication after radical neck dissection. We report a case of bilateral chylothorax that developed after left radical neck dissection. A 40-year-old man was given a diagnosis of secondary left cervical lymph-node metastasis from left-sided tongue cancer (T1N0M0), and supraomohyoid neck dissection was performed. Since multiple lymph-node metastases had been found, modified radical neck dissection was performed. We ligated the thoracic duct because it ruptured intraoperatively. On the first postoperative day, a chyle leak was diagnosed, and the thoracic duct was ligated again. The chyle leak resolved, but on the fourth postoperative day, the patient complained of dyspnea and chest discomfort. Computed tomographic scans and chest X-ray films showed bilateral pleural effusions. Diagnostic thoracentesis was performed. Milky fluid was aspirated, and chylothorax was diagnosed. We used a conservative management approach, which involved total parenteral nutrition with total enteric rest. Repeated chest X-ray films showed no evidence of pleural effusion, and the patient was started to receive a low-fat diet on the 11th postoperative day. The patient had recovered completely.

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© 2015 社団法人 日本口腔外科学会
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