Article Text

NEONATAL CHYLOTHORAX: 10 YEARS OF EXPERIENCE IN A TERTIARY LEVEL NEONATAL UNIT
  1. C Kortsalioudaki1,
  2. H Katugampola1,
  3. M Sellwood1
  1. 1University London College Hospital, London, UK

Abstract

Objective To review the management and outcome of infants with chylothorax admitted to a tertiary level neonatal unit over the past decade.

Methods Records of neonates admitted with a diagnosis of chylothorax between January 1997-March 2008, were reviewed. Chylothorax was confirmed by lymphocytosis in the pleural fluid±raised triglycerides.

Results Twelve neonates, with chylothorax were identified during the study period. Five were male. Eight were antenatally diagnosed and of these, five had antenatal pleurocentesis. Three were associated with non-immune hydrops; one had trisomy-21. Four neonates developed iatrogenic chylothoraces following surgery (2 post PDA-ligation, 1 following tracheo-oesophageal fistula and 1 post diaphragmatic hernia repair).

Three infants underwent surgery for chylothorax (1 had thoracic duct ligation, 1 pleurodesis and 1 pleuro-peritoneal shunt). Two infants died post-operatively one with fulminant necrotising enterocolitis, the other from complications of cardiac surgery.

Conclusions The majority of infants in our series survived, all the infants required significant periods of intensive care. This information is of value in counselling parents and planning care for these infants. Experience in the use of octreotide is still limited; surgery should be reserved for refractory cases.

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