Treatment of chylothorax in a premature infant using somatostatin.
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We describe a case of spontaneous chylothorax in a premature infant successfully treated by octreotide after other forms of conservative therapy were not effective. (+info)
Ligation of the thoracic duct for the treatment of chylothorax in heart diseases.
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In children, chylothorax occurs mainly after cardiac and thoracic surgeries. One of the recommended postsurgery treatments is ligation of the thoracic tract, when all other conservative treatments have failed. We report 4 cases of chylothorax in patients who were successfully treated with this approach, which resulted in a decrease in pleural drainage without recurrent chylothorax. (+info)
Congenital idiopathic chylothorax in neonates: chemical pleurodesis with povidone-iodine (Betadine).
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Chylothorax is defined as an accumulation of chyle in the pleural space. This condition usually occurs after an operation, the congenital idiopathic form being rare (1/15000 births). Recovery is observed within four to six weeks of diagnosis in most cases. Treatment is either conservative or surgical. Four cases are reported of congenital chylothorax (three idiopathic, one accompanied by diffuse lymphangectasia) managed by chemical pleurodesis (intrapleural injection of povidone-iodine). Tolerance was satisfactory: unaltered thyroid function in the three cases explored; one case of transient generalised oedema. Treatment was deemed successful in three of the four cases. One child died from renal failure (unrelated to the chemical pleurodesis). Pleurodesis by povidone-iodine appears to be well tolerated and may represent a good alternative to mechanical abrasion or surgery for congenital idiopathic chylothorax. Its use for refractory chylothorax may also decrease the morbidity related to prolonged hospital stay. (+info)
Catheter-related superior vena cava syndrome complicated by chylothorax in a premature infant.
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A premature infant experienced respiratory distress due to chylothorax. Contrast-enhanced chest computed tomography showed superior vena cava (SVC) obstruction with collaterals, and surgery confirmed an obstruction of the SVC by intravascular fibrotic tissue and thrombi caused by placement of a central venous catheter. The respiratory distress improved after surgical intervention. In the differential diagnosis of acute respiratory distress, it is necessary to consider catheter-related chylothorax and SVC syndrome when a previously stable patient has an acute change in cardiopulmonary status, regardless of the duration of catheter use. Although often considered safe and easy, central venous catheter placement may result in complications. Using appropriate catheters and choosing proper insertion sites can minimize these events. Early diagnosis and treatment can be life-saving should complications occur. (+info)
The medical management of idiopathic chylothorax in a domestic long-haired cat.
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A 3-year-old, spayed female domestic long-hair was evaluated for a 2-week history of progressive tachypnea. Chylothorax was diagnosed through radiographic and pleural fluid evaluation. No primary cause was identified and the cat was managed medically. Thoracocentesis, dietary management, and oral rutin therapy resulted in substantial improvement of this idiopathic condition. (+info)
Human herpes virus 8-negative primary effusion lymphoma (PEL) in a patient after repeated chylous ascites and chylothorax.
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We describe a case of malignant lymphoma which presented in the body cavities without identifiable tumor masses. Malignant lymphoma cells showed strong atypia with prominent nuclei and basophilic cytoplasm containing vacuoles. The chromosomes showed diploidy and complex abnormalities including translocations and deletions. We diagnosed this patient with primary effusion lymphoma (PEL), even though she tested negative for human herpes virus-8 (HHV-8) which has been suggested to be causally related to PEL. Interestingly, the patient also showed complicated protein-losing enteropathy, and PEL occurred after repeated chylous ascites and chylothorax. The possible pathogenesis of this rare disease is discussed here. (+info)
Chylous ascites and chylothorax due to constrictive pericarditis in a patient undergoing haemodialysis.
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Chylous ascites and chylothorax are rare clinical entities and usually caused by neoplasms, particularly lymphomas, liver cirrhosis, superior vena cava thrombosis, nephrotic syndrome, and some cardiac events such as dilated cardiomyopathy or right heart failure. Constrictive pericarditis is an extremely rare cause of this clinical state. We report a 41-year-old male patient undergoing haemodialysis who presented with chylous ascites and chylothorax. Echocardiography and heart catheterisation revealed constrictive pericarditis. He underwent pericardiectomy and after the operation the ascites and pleural effusion resolved rapidly. We suggest that constrictive pericarditis should be considered in the differential diagnosis of chylous ascites and chylothorax. (+info)
Chylothorax as a complication of oesophageal sclerotherapy.
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Chylothorax is an unusual complication of sclerotherapy for oesophageal varices. A patient is described in whom a massive chylous effusion followed sclerotherapy with repeated injections of 1.5% sodium tetradecyl sulphate. The thoracic duct traverses the posterior mediastinum in close proximity to the oesophagus, and may be disrupted by injections at mid oesophageal level. (+info)