頸部郭清術後に生じた乳び胸の1例

A case of portal venous gas during chemoradiotherapy with cetuximab for hypopharynx carcinoma

はじめに

　乳び胸とは，胸管から漏出した乳びが胸腔内に貯留した状態である。発症すると重篤な呼吸障害や循環障害をきたすことがあり，注意を有する合併症であり，的確な診断や治療が必要である。特に，頸部郭清術後に生じる合併症のうち乳び胸は非常に稀である。今回われわれは，術後2日目に呼吸苦，胸水貯留が出現し，術後3日目に乳び胸と診断し，保存的加療により軽快した症例を経験したので報告する。

　Chylothorax is a rare complication following neck dissection. Care must be taken because serious respiratory and circulatory disturbances may occur. This case involves a male patient diagnosed with cancer of the left parotid gland. The patient was treated with left modified radical neck dissection and heavy-ion radiotherapy. The patient showed breathing difficulties and pleural fluid on postoperative chest radiography. The pleural effusion puncture revealed a chylothorax. Conservative treatment was successful including techniques such as local compression, drainage, nutritional management and/or IVH. We diagnosed this case relatively early, and obtained good results with conservative treatment.