title: Report of three cases: congenital chylothorax and treatment modalities.
abstract: Chylothorax is the most common cause of pleural effusion in the newborn. We report three patients with congenital chylothorax and discussed the clinical course and treatment options. Cases 1 and 2 with congenital chylothorax were treated by chest tube placement and total parenteral nutrition (TPN), and were fed a formula rich in medium-chain triglyceride. They were discharged home without any sequelae. Our 3rd case with chylothorax did not respond to the conventional therapies. Octreotide infusion was tried without any benefits and necessitated surgical intervention, but the infant developed chronic lung disease requiring nasal oxygen therapy until three months of age. All three patients developed complications of chylothorax treatment like chest tube dysfunction, pneumothorax, nosocomial sepsis, and cholestasis. Management of congenital chylothorax necessitates a multidisciplinary approach. Treatment options include pleural drainage, cessation of enteral feeding and initiation of TPN. Experience with octreotide treatment is limited. Surgery should be reserved for severe and refractory cases.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Marmara University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Emel
authors.initials: E
authors.lastname: Altuncu
authors.forename: Ipek
authors.initials: I
authors.lastname: Akman
authors.forename: Gürsu
authors.initials: G
authors.lastname: Kiyan
authors.forename: Refika
authors.initials: R
authors.lastname: Ersu
authors.forename: Ziya
authors.initials: Z
authors.lastname: Yurdakul
authors.forename: Hülya
authors.initials: H
authors.lastname: Bilgen
authors.forename: Tutku
authors.initials: T
authors.lastname: Ozdoğan
authors.forename: Eren
authors.initials: E
authors.lastname: Ozek
mesh_terms: D015505:Chest Tubes; D002916:Chylothorax / Q000150:complications / Q000151:congenital* / Q000000981:diagnostic imaging / Q000628:therapy*; D018752:Diet, Fat-Restricted; D004322:Drainage; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications; D041943:Infant Formula / Q000008:administration & dosage / Q000737:chemistry; D007231:Infant, Newborn; D008297:Male; D015282:Octreotide / Q000627:therapeutic use; D010289:Parenteral Nutrition, Total; D011859:Radiography; D013004:Somatostatin / Q000031:analogs & derivatives
chemical_list: D013004:Somatostatin; D015282:Octreotide