RESUMO
Chylothorax, a relatively rare condition of pleural effusion, is defined as an accumulation of chyle resulting from damage to the thoracic duct associated with chyle leakage from the lymphatic system into the pleural cavity. The etiologies of this condition are numerous, and the most important approach for management of chylothorax is to determine the definite cause. We report on a case of an unusual complication of chylothorax that occurred after central catheterization and direct instillation of total parenteral nutrition into the pleural cavity.
Assuntos
Cateterismo , Cateterismo Venoso Central , Catéteres , Quilo , Quilotórax , Sistema Linfático , Nutrição Parenteral , Nutrição Parenteral Total , Cavidade Pleural , Derrame Pleural , Veia Subclávia , Ducto TorácicoRESUMO
Percutaneous endoscopic gastrostomy (PEG), which was first introduced in 1980, was quickly adopted for use in pediatric and adult patients. However, problems such as severe kyphoscoliosis, interposed organs, or other forms of distorted anatomy, may prevent effective and safe PEG tube placement. In such cases, laparoscopy-assisted PEG (LAPEG) is a useful optional procedure for patients with distorted anatomy and an initial unsuccessful PEG attempt. Furthermore, less invasive measures are preferable over surgical gastrostomy. We present a 27-year-old-male patient with severe kyphoscoliosis and a history of PEG-related complications with a colocutaneous fistula appearing 10 months earlier in whom a feeding tube was successfully placed by LAPEG. There were no LAPEG-related complications in the perioperative period, either technical or metabolic. After discharge, the patient was effectively fed using the bolus method.