A clinical study of congenital chylothorax and octreotide therapy.
10.3345/kjp.2008.51.11.1172
- Author:
Ung Geon OH
1
;
Kyoung Eun CHOI
;
Kyung Ah KIM
;
Sun Young KO
;
Yeon Kyung LEE
;
Son Moon SHIN
Author Information
1. Department of Pediatrics, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea. kkaped@medimail.co.kr
- Publication Type:Original Article
- Keywords:
Congenital chylothorax;
Octreotide;
Hydrops fetalis;
Clinical study
- MeSH:
Chyle;
Chylothorax;
Delivery of Health Care;
Exudates and Transudates;
Female;
Hospitals, General;
Humans;
Hydrops Fetalis;
Incidence;
Infant;
Infant, Newborn;
Lymphocytes;
Medical Records;
Milk;
Octreotide;
Retrospective Studies;
Thoracostomy;
Ventilation;
Vomiting
- From:Korean Journal of Pediatrics
2008;51(11):1172-1178
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Congenital chylothorax is an accumulation of lymphatic fluid within the pleural space. It is a common cause of unidentified hydrops fetalis. We examined the perinatal history, clinical manifestation, diagnosis, treatment, and outcome in 6 newborns diagnosed to have congenital chylothorax with hydrops fetalis. We also studied the effect of octreotide therapy for congenital chylothorax in relation to conservative treatment. METHODS: We retrospectively reviewed the medical records of 6 patients diagnosed to have congenital chylothorax with hydrops fetalis among 27,907 newborns who were born at the Cheil General Hospital and Womens Healthcare Center between January 2004 and July 2007 . The diagnosis of chylothorax is based on the analysis of pleural fluid before and after milk feeding. RESULTS: Incidence of congenital chylothorax in this study was 0.021%. All 6 cases were noted in over the 92% lymphocyte in pleural analysis. Transudate was changed into chyle with increasing triglyceride levels above 200 mg/dL after milk feeding. Three of 6 infants improved with conservative treatment, including thoracostomy and assisted ventilation. The others had persistent symptoms despite conservative treatment and responded to octreotide therapy. A complication, specifically vomiting was noted in 1 case during octreotide therapy. CONCLUSION: In this study, octreotide therapy resulted in a safe and excellent outcome. Therefore, octreotide therapy is considered in severe refractory congenital chylothorax in conservative treatment. Further studies are required to determine appropriate guidelines for octreotide therapy.
