Conservative treatment of unilateral chylothorax developed after radical neck dissection: A case report

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  • Goto Yuichi
    Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University
  • Imamura Haruyuki
    Department of Oral and Maxillofacial Surgery, Kagoshima Prefectural Oshima Hospital
  • Sakamoto Ryoichi
    Department of Oral Surgery, Jiaikai Imamura General Hospital
  • Uchino Yoshinori
    Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University
  • Hijioka Hiroshi
    Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University
  • Sugiura Tsuyoshi
    Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University

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  • 全頸部郭清後に生じた片側乳糜胸に対する保存治療を行った1例

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Abstract

A 60-year-old woman was shown to have an ulceration, measuring approximately 20×30mm, and induration in the left mandibular gingiva, during her first medical examination. Based on imaging and histopathology results, the patient was diagnosed with squamous cell carcinoma （cT2N2bM0）. We performed left-sided radical neck dissection and left-sided mandibular border resection under general anesthesia. After the surgery, blood-like aspirate was observed in continuous aspiration; however, the volume of this fluid gradually decreased on the same day. However, on the second day, the patient gradually experienced breathing difficulty at night. The left lung was found to be non-hyperpermeable, and the diaphragm corner movement was observed to slow down. Chest radiography on the third day revealed a mediastinal shift. We consulted internal pulmonary medicine specialists and enforced left chest drainage. The patient was diagnosed with left chylothorax, and conservative treatment was initiated. After three days of peripheral parenteral nutrition, we switched to a diet comprising nearly fat-free oral formula for two weeks.

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