Neonatal chylothorax

Authors

  • Tejinder P. Kaur Department of Pediatrics, Shri Guru Ram Das Institute of Medical Science and Research, Amritsar, Punjab, India
  • Gursharan S. Narang Department of Pediatrics, Shri Guru Ram Das Institute of Medical Science and Research, Amritsar, Punjab, India
  • Ashiana S. Department of Pediatrics, Shri Guru Ram Das Institute of Medical Science and Research, Amritsar, Punjab, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20192055

Keywords:

Chylothorax, Lymphatic fluid, Patent ductus arteriosus, Pleural effusion, Somatostatin analogue

Abstract

Chylothorax is the most common form of pleural effusion encountered in neonates. It is defined as abnormal accumulation of lymphatic fluid in the pleural space. It may be either congenital or an acquired condition. It causes respiratory and nutritional problems and significant mortality rate. Neonatal chylothorax respond to octreotide treatment. Octreotide is a long-acting somatostatin analog that can reduce lymphatic fluid production and has been used as a new strategy in the treatment of chylothorax.   Initial management may include restriction of enteral feedings. Authors report a case of newborn baby born to gravida 2 mother at 32±2 weeks of gestation with left sided pleural effusion subsequently confirmed to be a congenital chylothorax with patent ductus arteriosus. USG guided tap was done, and milky fluid was aspirated.

References

Van Straaten HL, Gerards LJ, Krediet TG. Chylothorax in the neonatal period. Europe J Pediatr. 1993;152(1):2-5.

Beghetti M, La Scala G, Belli D, Bugmann P, Kalangos A, Le Coultre C. Etiology and management of paediatric chylothorax. J Pediatr. 2000;136(5):653-8.

Dubin PJ, King IN, Gallagher PG. Congenital chylothorax. Current Opinion Pediatr. 2000;12(5):505-9.

Wasmuth‐Pietzuch A, Hansmann M, Bartmann P, Heep A. Congenital chylothorax: lymphopenia and high risk of neonatal infections. Acta Paediatr. 2004;93(2):220-4.

Soto-Martinez M, Massie J. Chylothorax: diagnosis and management in children. Paediatr Resp Rev. 2009;10(4):199-207.

Roehr CC, Jung A, Proquitté H, Blankenstein O, Hammer H, Lakhoo K, et al. Somatostatin or octreotide as treatment options for chylothorax in young children: a systematic review. Intensive Care Med. 2006;32(5):650-7.

Bulbul A, Okan F, Nuhoglu A. Idiopathic congenital chylothorax presented with severe hydrops and treated with octreotide in term newborn. J Maternal Fetal Neonatal Med. 2009;22(12):1197-200.

Young S, Dalgleish S, Eccleston A, Akierman A, McMillan D. Severe congenital chylothorax treated with octreotide. J Perinatol. 2004;24(3):200.

Altuncu E, Akman İ, Kiyan G, Ersu R, Yurdakul Z, Bilgen H, et al. Report of three cases: congenital chylothorax and treatment modalities. Turkish J Pediatr. 2007;49(4).

Matsukuma E, Aoki Y, Sakai M, Kawamoto N, Watanabe H, Iwagaki S, et al. Treatment with OK-432 for persistent congenital chylothorax in newborn infants resistant to octreotide. J Pediatr Surg. 2009;44(3):e37-9.

Jalili FI. Medium-chain triglycerides and total parenteral nutrition in the management of infants with congenital chylothorax. Southern Med J. 1987;80(10):1290-3.

Simmonds WJ. The effect of fluid, electrolyte and food intake on thoracic duct lymph flow in unanaesthetized rats. Aus J Exp Bio Med Sci. 1954;32(3).

Crandall L. A study of the lymph flow from a patient with thoracic duct fistula. Gastroenterol. 1943;1:1040-5.

Büttiker V, Fanconi S, Burger R. Chylothorax in children: guidelines for diagnosis and management. Chest. 1999;116(3):682-7.

Soto-Martinez ME, Clifford V, Clarnette T, Ranganathan S, Massie RJ. Spontaneous chylothorax in a 2-year-old child. Med J Aus. 2009;190(5):262-4.

Glaser B, Hirsch HJ, Landau H. Persistent hyperinsulinemic hypoglycemia of infancy: long-term octreotide treatment without pancreatectomy. J Pediatr. 1993;123(4):644-50.

Tauber MT, Harris AG, Rochiccioli P. Clinical use of the long acting somatostatin analogue octreotide in pediatrics. Eur J Pediatr. 1994;153(5):304-10.

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Published

2019-04-30

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Section

Case Reports