Congenital Chylothorax: Diagnosis Problems

Abstract

Fetal pleural effusion is most frequently a marker of chylothorax. It is usually unilateral and frequently located on the right side, due to the anatomical position of the thoracic duct. Fetal hydro thorax can be either primary or secondary to chromosomal, cardio vascular, hematologic, liver or metabolic diseases, con genital infections and skeletal dysplasia, or placenta or cord abnormalities.Congenital chylothorax in the newborn can be associated with symptoms of severe respiratory distress, requiring rapid evacuation and respiratory support. In chylothorax, the appea rance of the fluid is milky, yellowish, with a high cell count and increased level of triglycerides.The treatment of neonatal chylothorax involves removal of substantial effusion, pleural drainage and initiation of a special diet to limit chylothorax fluid restoration.This paper presents the case of a premature newborn at a gestational age of 36 weeks, with fetal hydrothorax, which was diagnosed in utero at 28 weeks of pregnancy. After the initial resorption of the pleural effusion, it restored in parallel with the increasing quantity of ingested breast milk.