Thoracic duct injury after AO C thoracic spine fracture: A case report

Abstract

PurposeTo describe the rare complication of traumatic thoracic duct injury associated significant thoracic spine fractures and describe treatment when conservative treatment is refractory. ResultsA 27-year-old male was admitted to the hospital after a motorcycle collision with a three-column extension injury of spinal levels T9-10 and a traumatic thoracic duct injury that was clinically detected on hospital day 9. This case reports documents successful management of a traumatic chylothorax via thoracic duct embolization. Thoracic duct injury is a rare sequela of vertebral fractures. Drainage and observation is considered first line treatment of a chylothorax. However, surgery is indicated if leakage persists after parenteral feeding and a strict non-fat diet for 5–7 days. This case represents a unique instance where a traumatic spine injury was seen in association with thoracic duct injury and chylothorax. ConclusionsTraumatic thoracic duct injury can occur with significant thoracic spine injuries. Being aware of this potential concomitant injury will prevent a delayed or missed diagnosis. Despite literature that shows that this can be managed conservatively, there are circumstances such as our case where treatment is refractory to non-procedural management. Our case is unique in its description of management in regards to minimally invasive approach to traumatic thoracic duct injury in the context of a spinal fracture.