Barba-Robles AP, Ordóñez-Gutiérrez EA, Jiménez-Urueta PS, Sánchez-Michaca VJ, Castañeda-Ortiz RA

Language: Spanish
References: 10
Page: 7-10
PDF size: 59.59 Kb.

ABSTRACT

Introduction: Neonatal chylothorax is an uncommon cause of respiratory distress in the newborn. It may result from anomalous lymph drainage with or without associated aneuploidy syndromes, i.e. trisomy, Turner’s syndrome, Noonan’s syndrome, from injury to the thoracic duct, or from obstruction of the superior vena cava. Chylothorax, which is usually idiopathic, is the most common form of pleural effusion in the newborn. We report the case of an infant with spontaneous chylothorax who responded well to conservative treatment.
Case report: We report a 3-week-old infant who had spontaneous chylothorax, and pleural effusion which caused respiratory distress. A roentgram showed pleural effusion, solved with percutaneous chest drainage. The patient was given parenteral and enteral feeding of a formula high in medium-chain triglycerides. Neonatal chylothorax responds well to conservative treatment, which shortens the duration of hospitalization.
Discussion: Neonatal chylothorax is an uncommon cause of respiratory distress in the newborn. It is the most common cause of pleural effusion causing respiratory distress in the neonate. Cases who do not respond to conservative management usually require surgery. We report a case of spontaneous neonatal chylothorax where surgery was avoided and was treated with special diet. The chylothorax resolved promptly with no side effects. Neonates with isolated spontaneous chylothorax differ from those with associated major cardiac malformations. They are at a lower risk for adverse effect of management. We conclude that high in medium-chain triglycerides formula is followed by a good respons.

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