Congenital Chylothorax: Management by Ligature of the Thoracic Duct

Abstract

Congenital chylothorax in a male infant persisted for 10 weeks despite repeated thoracocenteses and dietary regimens which included total parenteral nutrition for 37 days and a peroral semielementary diet with medium-chain triglyceride content for 19 days. Thoracotomy disclosed a small leak in the thoracic duct. The duct was ligated above and below the leak, as attempted repair was unsuccessful. There was no recurrence of pleural effusion after the operation and no distal lymphoedema was observed.

Octreotide as therapeutic option for congenital idiopathic chylothorax: a case series

“…The optimal treatment of CC has not been defined. Conservative treatment [low‐fat high‐protein diets with medium‐chain triglycerides (MCT), total parenteral nutrition, pleural drainage, use of positive end expiratory pressure during mechanical ventilation and chemical (7) or mechanical pleurodesis] and surgical intervention thoracoscopic pleurodesis, pleuroperitoneal pump (8), surgical abrasion, ligation of the thoracic duct (9) and creation of a thoracic duct to azygous vein anastomosis have (10) been performed.…”

Successful treatment of familial congenital chylothorax by ligation of the thoracic duct: A case report

“…The first successful transthoracic ligation of the thoracic duct was performed by Lampson in 1946 and the specific surgical procedure has major impact on the treatment of chylothorax in children [14], [15]. Success rate of surgical treatment can reach up to 90%, although in up to 11% of patients more than one attempt is demanded to achieve the desired outcome.…”

Quilopericárdio isolado após cirurgia cardíaca

“…Lymph is composed of a material rich in proteins and fat, which is conducted from the periphery of the tissues and intestine to the vascular system, initially inside small canaliculi, and then to the cisterna magna and thoracic duct [6][7][8] . All lymph in the body follows this trajectory, reaching the innominate vein near the point where the internal jugular vein arrives.…”

“…Lymph originating from the right half of the head and right upper limb drains into an accessory duct, to the right, in the superior vena cava. Approximately 1.5 to 2.0 liters of lymph flow daily inside the thoracic duct and discharge into the superior vena cava [6][7][8] . When the lipid and protein contents of lymph are increased, it is called chyle, and when this occurs, the total volume is increased [6][7][8] .…”