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PubMed1977

Medium chain triglycerides for treatment of spontaneous, neonatal chylothorax. Lipid analysis of the chyle.

Volume and contents of lipid and protein in the pleural fluid from a three weeks old girl with spontaneous chylothorax were studied (a) during parenteral, nonfatty nutrition and later (b) during administration of a formula (Biosorbin) containing medium chain triglycerides (MCT). The pleural fluid production could not be correlated to the treatment employed but suddenly ceased after 20 days management. Triglyceride and total esterified fatty acid concentrations in pleural fluid were high on admission when feeded with human milk, and chylomicrons and other lipoproteins were present in the chyle. During parenteral treatment a pronounced decrease in pleural fluid concentrations of triglyceride and total fatty acids occurred concomitant with a disappearance of the chylomicrons. During the following MCT diet a pronounced increase in triglyceride and total fatty acids concentrations appeared and the chylomicrons reappeared in the chyle. The cholesterol and phospholipid concentrations in the pleural fluid showed only small changes during the different treatments. No significant changes in protein and albumin concentrations of chyle were observed. It is concluded, that administration of the Biosorbin MCT formula, containing 871/2% of the fat as MCT, seems without value ih the treatment of spontaneous, neonatal chylothorax.

Chyle↗
PubMed2005

Congenital chylothorax associated with isolated congenital hypoplastic superior caval vein: a case report.

UNLABELLED: Congenital absence, or hypoplasia, of the superior vena cava (SVC) with situs solitus is quite uncommon. Most cases have been found incidentally and concomitant with left persistent SVC or other cardiac disorders. Congenital chylothorax may be associated with cardiac anomalies, various syndromes, thoracic ductal or venous thrombosis, birth trauma or local compression of the thoracic duct, but it is rarely caused directly by congenital SVC anomalies. CONCLUSION: We report a rare case of congenital chylothorax associated with isolated congenital hypoplastic SVC and underdeveloped collateral circulation.

Abnormalities, Multiple↗
PubMed1995

Chylothorax due to Mycobacterium tuberculosis.

Chylothorax in an adult is a rare cause of pleural effusion. Mycobacterium tuberculosis may cause chylous effusion, but usually in association with extensive intrapulmonary involvement. A case of chylothorax is presented in which M tuberculosis was isolated from the pleural fluid and was the only intrathoracic manifestation of tuberculosis.

Aged↗
PubMed1976

Postoperative chylothorax in children with congenital heart disease. Clinical and roentgenographic features.

The clinical and roentgenographic findings in 11 children were reviewed following development of a chylothorax after surgery for the management of congenital heart disease. The operative site in most cases was in proximity to the aortic isthmus. The pleural effusion was delayed in onset, reaccumulated rapidly after initial thoracentesis, and frequently recurred after apparent resolution. In most patients, widening of the mediastinum was noted prior to the appearance of the pleural effusion. Anatomical features of the thoracic duct and pathophysiologic concepts operative in chylothorax are reviewed and related to the clinical and roentgenographic characteristics of this entity.

Adolescent↗
PubMed1986

Retrosternal goiter and chylothorax: case report.

We describe a case of chylothorax associated with a retrosternal goiter. Such an association has not been previously reported. The chylothorax was probably caused by compression of the thoracic duct and brachiocephalic vessels.

Aged↗
PubMed1989

Chylothorax: a complication of the nephrotic syndrome.

A 50-yr-old man with the nephrotic syndrome developed a chylothorax that was shown to be due to transdiaphragmatic movement of chylous ascites. Because a significant number of patients with nephrotic syndrome have been reported to have chylous ascites, the possibility that chylothorax is due to movement of chylous ascites into the pleural space should be considered prior to surgical intervention directed toward repair of the thoracic duct.

Chylothorax↗
PubMed1988

Behçet's disease with chylothorax--case report.

Behçet's disease is a systemic disease primarily affecting the eye, genital, and oral mucosa but is known to have various rare complications. A patient with a twenty-year history of Behçet's disease was admitted owing to dyspnea caused by massive chylothorax. Administration of corticosteroid, heparin, and urokinase was ineffective, but the thoracic fluid was well controlled by pleuropexy with Broncasma Berna. Chylothorax complicating Behçet's disease is extremely rare, having been reported in only 2 cases.

Adult↗
PubMedDate not supplied

Chylothorax--a complication of subclavian vein catheterization.

Insertion complications of subclavian vein catheter placement are well documented. Thoracic duct injury is a potential problem which has rarely been reported. A patient with duct injury and resultant chylothorax is presented. The management of this problem is discussed with emphasis placed on chyle leakage from both the nutritional and mechanical aspect. The anatomy and function of the thoracic duct as well as the pathophysiology and treatment of chylothorax are detailed.

Aged↗
PubMed2002

Congenital pulmonary lymphangiectasia with chylothorax.

A 5-year-old boy with dyspnea was diagnosed through thoracentesis as having chylothorax. After conservative management failed, open thoracotomy was performed. Lung biopsy confirmed the diagnosis of congenital pulmonary lymphangiectasia. Chylothorax was successfully controlled by fibrin glue pleurodesis in this patient.

Child, Preschool↗
PubMed2003

Chylothorax following coronary bypass grafting: treatment by talc pleurodesis.

Chylothorax after myocardial revascularization is a rare but serious complication. There is as yet no definitive treatment. We report a case in which chylothorax was diagnosed on the 3rd postoperative day. Conservative management with dietary restriction to medium-chain triglyceride led to reduction of chyle leakage from 300 to 400 mL/day to 50 to 60 mL/day 3 days later. However, the leak persisted until talc pleurodesis was performed.

Chylothorax↗
PubMed2005

Conservative management of postsurgical chylothorax with octreotide.

Postsurgical chylothorax after lung resection has an important associated rate of morbidity and mortality, and a large proportion of cases require re-exploration. The most desirable and least aggressive option is conservative treatment. The use of octreotide seems to be associated with a higher rate of resolution without the need for surgical intervention. We present 4 cases in which this drug showed excellent efficacy and minimal adverse effects in the resolution of postsurgical chylothorax.

Adult↗
PubMed1994

Chylothorax after endoscopic sympathectomy: case report.

Endoscopic sympathectomy is a new trend for the treatment of hyperhidrosis palmaris. It is a simple and effective technique; however, it carries some recognized risks such as Horner's syndrome and pneumohemothorax. We recently encountered a case complicated by the development of a chylothorax. The patient was a 23-year-old healthy women with profuse palmar sweating. She developed an intractable dry cough after a transthoracic endoscopic sympathectomy. A chest x-ray revealed a left pleural effusion. A chylous effusion was found after thoracentesis and fluid analysis. The pleural effusion resolved after chest tube drainage and diet control. Although endoscopic sympathectomy is a simple and quick procedure, unusual complications, such as chylothorax, may occur. Appropriate early recognition and treatment can prevent a disastrous result.

Adult↗
PubMed1988

The role of lymphography in chylothorax following thoracic surgery.

Lymphography was used to investigate nine patients who presented with chylothorax after surgery of the thorax. Leakage of the lipiodol was identified from the thoracic duct in six patients and from tributaries of the thoracic duct in two patients. There was complete occlusion of the thoracic duct at the site of injury in two patients but leakage could not be visualized at the time of the procedure. The different methods of treatment of chylothorax and the influence of the lymphographic findings on management are discussed.

Chylothorax↗
PubMed1994

Chylothorax in Gorham's syndrome. A common complication of a rare disease.

One hundred forty-six cases of Gorham's syndrome are documented in the literature. Twenty-five (17 percent) patients have been reported to have chylothorax as a complication. To our knowledge, this high incidence of chylothorax has not been reported previously. We describe two such patients treated by thoracic duct ligation and compared our results with others to support early surgical intervention via a low right-sided thoracotomy in these cases.

Adolescent↗
PubMed1994

Retrosternal goiter associated with chylothorax.

We describe a case of chylothorax in a female patient with a large retrosternal goiter. After subtotal thyroidectomy by means of a Kocher cervicotomy, the chylothorax disappeared in 48 h. At present, 2 years after surgical removal, the patient remains asymptomatic, without recurrent pleural chylous effusion. Until now, to our knowledge, only one such case had been reported.

Aged↗
PubMed1978

Chylothorax as a manifestation of rheumatic mitral stenosis: its postoperative management with a diet of medium-chain triglycerides.

Chylothorax occurred as a manifestation of severe congestive heart failure resulting from rheumatic mitral stenosis. Following replacement of the mitral valve, chylothorax recurred and was treated by thoracocentesis initially and then resolved during six months of therapy with a diet of medium-chain triglycerides. Ultimately, the patient resumed a regular diet with no further accumulation of pleural fluid.

Chylothorax↗