Bilateral spontaneous chylothorax after severe vomiting in children

Rodrigues, Antonio Lucas Lima; Romaneli, Mariana Tresoldi das Neves; Ramos, Celso Darío; Fraga, Andréa de Melo Alexandre; Pereira, Ricardo; Appenzeller, Simone; Marini, Roberto; Tresoldi, Antônia Teresinha

doi:10.1016/j.rppede.2016.04.003

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…A blow to the posterior left thorax sufficient to fracture multiple ribs is more than sufficient to damage the nearby thoracic duct (1)(2)(3)(4). Arguing against this is most patients with large traumatic chylothoraces present within 10 days of injury (1,2).…”

Section: Figure 2 Thoracic Duct Anatomy (Black Arrows)mentioning

confidence: 99%

Infected chylothorax: a case report and review

Eubank¹,

Gabe²,

Kraft³

et al. 2018

Southwest J Pulm Crit Care

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Infected chylothorax is a rare complication of a rare pathology with limited literature entirely consisting of case reports, meeting abstracts, and letters to the editor. The case of a 56-year-old male with a spontaneous infected chylothorax successfully treated and discharged to home without any residual effects is described. A systematic review of the literature revealed 11 prior cases of infected chylothoraces. Their etiologies (when known), initial pleural fluid values, and treatment are described. These cases show that while infected chylothorax has a varied presentation and affects a broad range of patients, conservative management including antibiotics, pleural fluid drainage, and symptomatic relief is a safe and appropriate starting point.

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Section: Figure 2 Thoracic Duct Anatomy (Black Arrows)mentioning

confidence: 99%

Infected chylothorax: a case report and review

Eubank¹,

Gabe²,

Kraft³

et al. 2018

Southwest J Pulm Crit Care

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“…[49], [51-52], [54-58], [60-64], [66], [70][71][72][73][74][75][76][77][78][79][80][81], [84][85][86][87][88], [90][91][92][93], [95][96][97][98][99][100][101][102][103].…”

Section: Resultsmentioning

confidence: 99%

“…[55], [64], [64], [66], [71], [73], [74], [78], [90]- [93]. TPN allows for a faster reduction in pleural effusion [83].…”

Section: Resultsmentioning

confidence: 99%

Etiological factors and treatment of chylothorax in paediatric patients - a systematic review

Knop

Kochanowska

Piasecka

et al. 2022

J Educ Health Sport

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Chylothorax is an accumulation of chyle in the pleural cavity. It is a relatively rare cause of pleural effusion in children and its annual incidence is 14 cases per 100 000 children in Europe. The pleural fluid triglyceride level greater than 110 mg/dl with a cholesterol level lower than 200 mg/dl confirms the diagnosis of chylothorax. Medical imaging are also necessary such as a non-invasive and easily accessible lung ultrasound. Symptoms of this disease are tachypnea, dyspnea, and in some cases dry cough. This review aims to summarize the current literature regarding chylothorax in children, analyze its possible etiologies and treatments. The causes of chylothorax are varied. It may appear after surgical interventions, traumas, infections and also be congenital. Iatrogenic factors are the most common cause of chylothorax in children with cardiothoracic surgeries. Management of chylothorax can be quite complex and highly variable, depending on patient’s condition and their response to the introduced treatment. Conservative treatment consisting of nutrition therapy, chest drain, and pharmacotherapy is typically a first-line of treatment. Diet modification consist in dietary supplements enriched with medium chain triglycerides (MCT) or starting the patient on a total parenteral nutrition (TPN). In most of the analyzed cases the conservative treatment alone proved sufficient in the management of chylothorax. In case of its failure, surgical treatment was a secondary therapy choice. One of the most common surgical procedures for pleural effusion is a thoracic duct ligation (TDL) or pleurodesis and both of these methods are highly effective therapy for chylothorax. This review of the literature reveals a wide variety of causes and methods of treatment of chylothorax. There are no clear standards of management and the therapy is adjusted to the clinical condition of the patient.

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“…The incidence of congenital chylothorax is about 0.1 -0.5 %, and the case fatality rate is as high as 20 -50 % [2]. There are more males than females that are affected by this disease, and right-sided congenital chylothorax is more prevalent [3]. The occurrence of chylothorax is congenital, traumatic, tumorous, spontaneous and embolic, etc., and the delay of the disease may lead to severe respiratory, nutritional, and immune dysfunction, which is often the leading cause of death [2].…”

Section: Introductionmentioning

confidence: 99%

Effect of intrapleural injection of erythromycin on congenital refractory chylothorax in the newborn

Shi¹,

Zhang²

2020

Trop. J. Pharm Res

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Purpose: To investigate the therapeutic effect of intrapleural injection of erythromycin on congenital refractory chylothorax in the newborn, in order to provide a more efficient approach for its treatment.Methods: A retrospective study was conducted with 13 cases of congenital chylothorax in newborns that received conventional treatment and intrapleural injection of erythromycin.Results: A total of 10 out of 13 child patients (76.9 %) received active treatment. Furthermore, the patients who received the intrapleural injection of erythromycin were administered the injection a total of 1 - 3 times (1.5 ± 0.6) on the average with the dose ranging from 80 – 210 mg (mean, 126.5 ± 32.7 mg). Thereafter, they received continuous drainage for 7 – 12 days (mean time, 10.2 d). Drainage volume ranged from 50 - 150ml (mean, 84.3 ± 35.2 mL). Patients that did not receive the erythromycin treatment received continuous drainage for 5 – 13 d (mean, 8.6 day), with the drainage volume ranging from 67 - 132 mL (mean, 92.3 ± 25.6 mL).Conclusion: Therefore, intrapleural injection of erythromycin has a certain therapeutic effect on congenital refractory chylothorax in the newborn. Keywords: Erythromycin intrapleural injection, Congenital refractory chylothorax, Newborn

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Bilateral spontaneous chylothorax after severe vomiting in children

Cited by 5 publications

References 15 publications

Infected chylothorax: a case report and review

Infected chylothorax: a case report and review

Etiological factors and treatment of chylothorax in paediatric patients - a systematic review

Effect of intrapleural injection of erythromycin on congenital refractory chylothorax in the newborn

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