Bilateral spontaneous chylothorax after severe vomiting in children / Quilotórax bilateral espontâneo após vômitos excessivos em criança

Abstract Objective: To report the case of a child with bilateral chylothorax due to infrequent etiology: thoracic duct injury after severe vomiting. Case description: Girl, 7 years old, with chronic facial swelling started after hyperemesis. During examination, she also presented with bilateral pleural effusion, with chylous fluid obtained during thoracentesis. After extensive clinical, laboratory, and radiological investigation of the chylothorax etiology, it was found to be secondary to thoracic duct injury by the increased intrathoracic pressure caused by the initial manifestation of vomiting, supported by lymphoscintigraphy findings. Comments: Except for the neonatal period, chylothorax is an infrequent finding of pleural effusion in children. There are various causes, including trauma, malignancy, infection, and inflammatory diseases; however, the etiology described in this study is poorly reported in the literature.

Resumo Objetivo: Relatar o caso de uma criança com quilotórax bilateral devido a etiologia pouco frequente: lesão do ducto torácico após quadro de vômitos excessivos. Descrição do caso: Menina, sete anos, apresentava edema facial crônico iniciado após quadro de hiperemese. À avaliação, também apresentava derrame pleural bilateral, com líquido quiloso obtido na toracocentese. Após extensa investigação clínica, laboratorial e radiológica da etiologia do quilotórax, foi definido ser secundário a lesão do ducto torácico por aumento da pressão intratorácica pela manifestação inicial de vômitos, corroborado por achados de linfocintilografia. Comentários: À exceção do período neonatal, o quilotórax é achado infrequente de efusão pleural em crianças. As causas são diversas, incluindo trauma, neoplasia, infecção e doenças inflamatórias; contudo, etiologia como a aqui descrita é pouco relatada na literatura.

Quilotórax neonatal: a propósito de un caso / Neonate chylothorax: a purpose of a case

El quilotórax es una patología poco frecuente de la pleura, es la consecuencia de la acumulación de "quilo" o linfa procedente del conducto torácico hacia el espacio pleural. El quilotórax congénito es la principal causa de derrame pleural en el período neonatal. No se identifica una causa específica y puede poner en riesgo la vida del paciente, debe ser considerado como diagnóstico diferencial en cualquier recién nacido con problemas ventilatorios. Se reporta un caso de un neonato atendido en la unidad de neonatología del Hospital Luis Ortega de Porlamar, cabe resaltar que fue alimentado exclusivamente con leche materna

Isolated Non-chylous Pleural Effusion in Two Neonates

Isolated pleural effusion, so called primary pleural effusion denotes a pleural effusion without documented etiology such as a cardiac, inflammatory, iatrogenic problem or fetal hydrops. Chromosomal anomaly such as Down syndrome may be associated with isolated pleural effusion. The content of the isolated pleural effusion is mostly chylous, and isolated non-chylous pleural effusion in neonate is rare. We experienced 2 cases of isolated non-chylous pleural effusion. They had neither cardiac problem nor other sign of hydrops fetalis. Imaging diagnosis was done by plain chest radiography and subsequent ultrasonogram. One of them was diagnosed to Down syndrome by karyotyping. They were fared well after diagnostic and therapeutic thoracentesis. We describe 2 cases of non-chylous pleural effusion and review a few English-language case reports of this entity.

Chylous cysts of the mediastinum: report of a case and review of the literature

Life-threatening spontaneous chylothorax is a rare clinical entity. Correct diagnosis and understanding of its pathogenesis is paramount in order to apply definite surgical treatment. A case of a ruptured multilocular chylocyst around the thoracic duct and cysterna chyli is presented. Multiple bilateral aspirations, right thoracostomy, right thoracotomy, a frustrated attempt to ligate the thoracic duct, and an attempt to insert a pleuroperitoneal shunt, were all unsuccessful. Definite surgery accomplished rehabilitation of the patient after a 5 1/2 month hospitalization. Revision of the literature and vindicative historical facts are presented

Quilotorax traumático: caso clínico tratado con ligadura del conducto torácico / Traumatic chylothorax treated with ligature of thoracic duct

Se presenta un caso clínico de quilotórax izquierdo secundario a herida por arma blanca en la región cervical, tratado exitosamente con ligadura del conducto torácico a través de toracotomía izquierda. Se discute la etiopatogenia del quilotórax y su diagnóstico y tratamiento médico quirúrgico actual