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Chylothorax in newborn

Carlo Bellini, Rita Cabano, Laura C De Angelis, Tommaso Bellini, Maria G Calevo, Paolo Gandullia, Luca A Ramenghi
AIM: Chylothorax is a rare but life-threatening condition in newborns. Octreotide, a somatostatin analogue, is widely used as a therapeutic option in neonates with congenital and acquired chylothorax, but its therapeutic role has not been clarified yet. METHODS: We performed a systematic review to assess the efficacy and safety of octreotide in the treatment of congenital and acquired chylothorax in newborns. Comprehensive research, updated till 31 October 2017, was performed by searching in PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) databases using the MeSH terms 'octreotide' and 'chylothorax'...
March 30, 2018: Journal of Paediatrics and Child Health
Ryo Shirotsuki, Hiroo Uchida, Yujiro Tanaka, Chiyoe Shirota, Kazuki Yokota, Naruhiko Murase, Akinari Hinoki, Kazuo Oshima, Kosuke Chiba, Wataru Sumida, Masahiro Hayakawa, Takahisa Tainaka
BACKGROUND: Postoperative chylothorax after surgery for esophageal atresia/tracheoesophageal fistula (TEF) is a rare but serious complication, especially in neonates. This study aimed to identify the thoracic duct and ligate chylous leakage sites, using thoracoscopic navigation of an indocyanine-green (ICG)-based near-infrared (NIR) fluorescence imaging system. METHODS: From November 2014 to April 2017, thoracoscopic intraoperative ICG-NIR imaging was performed in 10 newborns (11 surgeries) with first TEF operation or with persistent postoperative chylothorax after TEF operation...
February 1, 2018: Journal of Pediatric Surgery
Nadia Kasdallah, Hakima Kbaier, Hatem Ben Salem, Sonia Blibech, Asma Bouziri, Mohamed Douagi
BACKGROUND: Povidone iodine (PVI) pleurodesis is commonly used in adult. However, this procedure is still nonconsensual in newborns. AIMS: This article aimed to report a new case of refractory congenital chylothorax (CCT) managed with PVI pleurodesis with a review of previousreported cases. METHODS: a systematic review of similar cases published in PubMed. Clinical patterns, therapeutic modalities and outcome variables werereported. RESULT: In a full term neonate presenting refractory CCT, PVI pleurodesis was performed at day 16 of life by one intrapleural instillation of PVI4% with rapid success and no side effects...
December 2016: La Tunisie Médicale
Ufuk Çakır, Dilek Kahvecioğlu, Duran Yıldız, Serdar Alan, Ömer Erdeve, Begüm Atasay, Saadet Arsan
Chylothorax is a relatively uncommon condition defined as an abnormal collection of lymphatic fluid within the pleural space. Morbidity of congenital chylothorax (CC) is high, and prognosis is very poor if CC is associated with hydrops fetalis. Although the optimal treatment of CC has not been determined, conservative treatment and surgical intervention are employed. However, there is still little experience with the use of octreotide therapy for this condition, and optimal duration of the treatment for response evaluation is not known...
March 2015: Turkish Journal of Pediatrics
Shahla Afsharpaiman, Mohammad Saeid Rezaee Zavareh, Mohammad Torkaman
INTRODUCTION: A rare condition in newborns called congenital chylothorax (CC) occurs when lymphatic fluid accumulates within the pleural cavity. Here is a presentation of a birth traumatic case with bilateral pleural effusion successfully treated by octreotide. CASE PRESENTATION: A 3100-g-term male newborn delivered vaginally from a 33-year-old mother was admitted to the neonatal intensive care unit with respiratory distress signs. Early chest x-ray (CXR) showed bilateral pleural effusion...
October 2015: Iranian Red Crescent Medical Journal
Federico Scottoni, Fabio Fusaro, Andrea Conforti, Francesco Morini, Pietro Bagolan
INTRODUCTION: Refractory chylothorax is a severe clinical issue, particularly in neonates. Conventional primary approach is based on diet with medium-chain fatty acids and/or total parenteral nutrition. In nonresponders, proposed second line treatments include chemical or surgical pleurodesis, thoracic duct ligation, pleuroperitoneal shunting and pleurectomy but none of these have been shown to be superior to other in terms of resolution rate and safety. Our aim is to report our experience on povidone-iodine use for chemical pleurodesis in newborn infants with chylothorax unresponsive to conservative treatment...
October 2015: Journal of Pediatric Surgery
Jariya Waisayarat, Chinnawut Suriyonplengsaeng, Chaiyos Khongkhatithum, Mana Rochanawutanon
INTRODUCTION: Nemaline myopathy is a rare genetic muscle disorder defined by the presence of nemaline rods in the muscle fibre sarcoplasm. Congenital nemaline myopathy is the most serious form of the disease's spectrum. CASE PRESENTATION: The affected newborn has no spontaneous movement, fractures at birth and respiratory insufficiency. The present case was a Thai male, floppy at birth with fractures of both humeri and femurs and ventilator-dependent respiration...
2015: Diagnostic Pathology
Kh Lomauri
Neonatal chylothorax results from the accumulation of chyle in the pleural space and may be either congenital or an acquired condition. Congenital chylothorax is most likely due to abnormal development or obstruction of the lymphatic system. It is often associated with hydrops fetalis. It can be idiopathic or may be associated with various chromosomal anomalies including Trisomy 21, Turner syndrome, Noonan syndrome, and other genetic abnormalities. Congenital pulmonary lymphangiectasia and generalized lymphangiomatosis have also been reported to be associated with congenital chylothorax...
November 2014: Georgian Medical News
Anja Bialkowski, Christian F Poets, Axel R Franz
BACKGROUND: Congenital chylothorax (CCT) is a rare disease of unknown aetiology. Treatment approaches vary; none has been evaluated prospectively. OBJECTIVE: To prospectively determine incidence, treatment and outcome of infants with CCT born in Germany in 2012. DESIGN: CCT was defined as non-traumatic chylous pleural effusion within 28 days after birth. As part of the Surveillance Unit for Rare Pediatric Conditions in Germany (Erhebungseinheit für seltene pädiatrische Erkrankungen in Deutschland), all paediatric departments (n=432) received monthly reporting cards to notify the study centre of CCT cases, which were analysed based on anonymised questionnaires and discharge summaries...
March 2015: Archives of Disease in Childhood. Fetal and Neonatal Edition
Dorota Nowakowska, Zuzanna Gaj, Mariusz Grzesiak, Ewa Gulczyńska, Jan Wilczyński
Primary fetal chylothorax is an uncommon complication, associated with high perinatal morbidity and mortality. In our report, we describe two cases of fetal bilateral primary chylothorax successfully treated with pleuro-amniotic shunting. In both cases, ultrasound scans showed bilateral, hypoechoic fluid in the pleural space without any associated structural malformations and features of infection and aneuploidy Laboratory analysis of pleural fluids revealed 79% and 92% of lymphocytes, respectively confirming chylothorax in both fetuses...
September 2014: Ginekologia Polska
Zafer Dokumcu, Ozgun Uygun, Tuncer Turhan, Mehmet Yalaz, Coskun Ozcan, Ata Erdener
BACKGROUND: Neuroenteric cysts (NC) are rare pathologies and localized generally in posterior mediastinum or abdomen where they may extend to spinal canal through a vertebral defect. Isolated spinal lesions require dorsal/ventral laminectomy and thoracic ones thoracotomy or thoracoscopy. Posterolateral approach via thoracotomy is generally performed for lesions with both thoracic and spinal components. Minimal invasive excision of a thoracic NC with spinal extension in an infant is presented herein...
February 2015: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
F Hmami, A Oulmaati, C Bouchikhi, A Banani, A Bouharrou
Idiopathic congenital chylothorax refers to abnormal accumulation of lymphatic fluid within the pleural space due the disruption of the thoracic duct or its lymphatic tributaries. It is a relatively rare disease and a cause of neonatal respiratory distress with major nutritional and immunological consequences. Therefore, it is critical to decrease pleural effusion promptly. Conservative treatment is always started as soon as the diagnosis is made, and refractory cases require chemical pleurodesis or surgery...
September 2014: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
C Bellini, G Villa, G Sambuceti, C Traggiai, C Campisi, T Bellini, G Morcaldi, D Massocco, E Bonioli, F Boccardo
We performed lymphoscintigraphy on 31 patients (newborns and children) affected by congenital lymphatic dysplasia according to our previously published protocol. Congenital lymphatic dysplasia may present with various degrees of clinical severity, ranging from nonimmune hydrops fetalis with visceral effusions to lymphedema alone. We recommend that lymphoscintigraphy should be strongly considered in all patients with signs of lymphatic dysplasia, including those with minimal and initial signs of lymphatic impairment, in order to obtain a very early diagnosis and to start treatment...
March 2014: Lymphology
Lai Shuan Wang, Hai Yan Wang, Wen Hao Zhou
OBJECTIVES: To investigate the clinical course and mid-term prognosis of neonates admitted with pleural effusion. METHODS: Case records of 38 neonates admitted with pleural effusion were retrieved and analyzed. RESULTS: 16 (42%) patients had congenital and 22 (58%) patients had acquired causes of pleural effusion. The most common causes of congenital pleural effusion and acquired pleural effusion were chylothorax (18%) and congestive heart failure (13%), respectively...
June 2014: Indian Pediatrics
Kurt R Schumacher, Tajinder P Singh, Joseph Kuebler, Kayla Aprile, Molly O'Brien, Elizabeth D Blume
BACKGROUND: The onset of plastic bronchitis (PB) can be debilitating in survivors of Fontan surgery. The rarity of this complication makes designing studies to understand risk factors for PB challenging. This 2-center case-control study aimed to describe patient outcomes and to assess the association of antecedent patient factors with PB development. METHODS AND RESULTS: Using center registries, PB patients (n=25) were matched 1:2 to non-PB Fontans (n=43) by date of Fontan surgery and center...
2014: Journal of the American Heart Association
V Gupta, N V Mahendri, P Tete, Sridhar Santhanam
BACKGROUND: Treatment for congenital chylothorax is based on adequate drainage of the pleural fluid and total parenteral nutrition followed by re-establishment of feeds using medium-chain-triglycerides based milk formulas which are expensive and not easily available. CASE CHARACTERISTICS: Two newborns (one term and one preterm) with congenital chylothorax. INTERVENTION: Skimmed milk preparation for enteral nutrition to provide high protein and low fat diet...
February 2014: Indian Pediatrics
Hava Tillipman Ladinsky, Miriah Gillispie, Panida Sriaroon, Jennifer W Leiding
Measurement of T-cell receptor excision circles (TREC) in neonates has allowed for population-based screening of severe combined immunodeficiency and other disorders associated with T-cell lymphopenia. In addition to primary T-cell lymphopenic disorders, secondary causes of T-cell lymphopenia can be diagnosed with TREC analysis. We discuss the diagnostic evaluation of a patient with normal TREC analysis at birth that became abnormal after cardiac surgery. TREC analysis was performed by the Florida State Laboratory...
November 2013: Journal of Allergy and Clinical Immunology in Practice
Jun Shibasaki, Hisako Hara, Makoto Mihara, Shinya Adachi, Yasushi Uchida, Yasufumi Itani
OBJECTIVES: To investigate the use of indocyanine green (ICG) lymphography in the diagnosis and assessment of the severity of lymphatic dysfunction in infants and neonates with congenital lymphatic pleural effusion and ascites. STUDY DESIGN: We performed ICG lymphography on 10 neonates and infants with congenital lymphatic pleural effusion and ascites. After the subcutaneous injection of ICG, circumferential fluorescent images of lymphatic drainage channels in the extremities and trunk were identified using an infrared camera system...
May 2014: Journal of Pediatrics
Salih Kalay, Osman Oztekin, Gonul Tezel, Burak Emre Demir, Mustafa Akcakuş, Nihal Oygur
Fetal pleural effusion is a rare condition. While it may regress spontaneously, it may also continue up to the post-natal period. This condition may be treated by thoracentesis, thoracoabdominal shunt application and pleurodesis in the intrauterine period while thoracentesis or tube thoracostomy may be used in the post-natal period. In cases where the fluid is defined to represent chylothorax, octreotide, a somatostatin analogue, may be administered for treatment. In this case report, we discussed the outcomes of treatment with octreotide administered in a neonatal case under follow-up due to fetal pleural effusion and with non-chylous ascites detected in the post-natal period...
October 2013: African Journal of Paediatric Surgery: AJPS
Li-Chin Yao, Chiara Testini, Denis Tvorogov, Andrey Anisimov, Sara O Vargas, Peter Baluk, Bronislaw Pytowski, Lena Claesson-Welsh, Kari Alitalo, Donald M McDonald
RATIONALE: Lymphatic vessels in the respiratory tract normally mature into a functional network during the neonatal period, but under some pathological conditions they can grow as enlarged, dilated sacs that result in the potentially lethal condition of pulmonary lymphangiectasia. OBJECTIVE: We sought to determine whether overexpression of the lymphangiogenic growth factor (vascular endothelial growth factor-C [VEGF-C]) can promote lymphatic growth and maturation in the respiratory tract...
February 28, 2014: Circulation Research
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