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

## TL;DR

This paper reports a rare case of cisterna chyli injury caused by a stab wound and highlights successful surgical management to prevent complications.

## Contribution

The novelty lies in being the first reported case of cisterna chyli injury caused by penetrating trauma.

## Key findings

- Cisterna chyli injury was successfully managed by clipping lymphatic branches during surgery.
- Intraoperative indocyanine green lymphangiography aided in identifying and controlling chyle leaks.
- The patient recovered well post-surgery and was discharged in good health.

## Abstract

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.