Breaking new ground: penetrating trauma and cisterna chyli injury: a case report.

J Surg Case Rep

Trauma and Acute Care Surgery Unit, Department of Surgery, College of Medicine, King Saud University, PO Box 2925, Riyadh 11461, Saudi Arabia.

Published: March 2025

Here we discuss a rare case of cisterna chyli injury resulting from penetrating trauma, with no prior reported cases in the literature related to such injuries caused by penetrating trauma. The patient, a 21-year-old male, presented with multiple stab wounds, prompting exploratory laparotomy. Penetrating wounds to the stomach and a pancreatic laceration with retroperitoneal hematoma were identified. Notably, chyle leakage from the cisterna chyli was managed by clipping lymphatic branches. The paper emphasizes the importance of intraoperative identification and control of chyle leaks, as they can impact nutritional status and wound healing. Various maneuvers, including intraoperative indocyanine green lymphangiography and postoperative monitoring of drain output, are discussed for detecting and managing chyle leaks. The patient's postoperative course was uneventful, highlighting successful management and discharge on Day 11 in good health.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881686PMC
http://dx.doi.org/10.1093/jscr/rjaf093DOI Listing

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