Preterm newborn with bilateral congenital chylothorax, a rare life-threatening entity
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Universidad Industrial de Santander
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El quilotórax corresponde a la acumulación de linfa en el espacio pleural. El diagnóstico se confirma por la presencia de quilomicrones en el líquido pleural, sin embargo en la práctica clínica se utilizan los criterios de Büttiker, para establecer el diagnóstico. El objetivo de esta publicación es presentar el caso de un recién nacido con quilotórax congénito bilateral, realizando una revisión actualizada del tema,que incentive la recolección de datos y la generación de guías nacionales para su abordaje estandarizado. Se trató de un recién nacido pretérmino, quien tras parto por cesárea presentó síndrome de distrés respiratorio, ameritó terapia temprana de surfactante logrando retiro de ventilación mecánica al día de vida, con posterior presentación de signos de dificultad respiratoria y hallazgo radiológico yecográfico de derrame pleural bilateral. Se realizó toracentesis con citoquímico compatible con quilotórax. Nuevamente ameritó soporte ventilatorio invasivo, toracostomía cerrada bilateral y nutrición parenteral, con posterior evolución clínica satisfactoria. MÉD.UIS. 2017;30(1):87-92.Palabras claves: Quilotórax Congénito. Síndrome de Dificultad Respiratoria del Recién Nacido. Derrame pleural. Prematuro.
Chylothorax refers to the accumulation of lymphatic fluid in the pleural space. Diagnosis is confirmed by the presence of chylomicrons in the pleural fluid, however in clinical practice Büttiker criteria are widely used. The aim of this publication is to present the case of a newborn with bilateral congenital chylothorax with an updated review of the literature that encourages data collection and generation of national guidelines for standardized approach. This was a newborn preterm, who after a cesarean delivery presented respiratory distress syndrome who required early surfactant therapy achieving withdrawal of mechanical ventilation on his first day, with subsequent presentation of signs of respiratory distress, and a radiological and ultrasound finding of bilateral pleural effusion. Thoracentesis was performed obtaining cytochemical compatible with chylothorax. Again required invasive ventilatory support, closed bilateral thoracostomy and parenteral nutrition, with a satisfactory clinical course. MÉD.UIS. 2017;30(1):87-92.Keywords: Congenital Chylothorax. Respiratory Distress Syndrome, Newborn. Pleural Effusion. Premature.
Chylothorax refers to the accumulation of lymphatic fluid in the pleural space. Diagnosis is confirmed by the presence of chylomicrons in the pleural fluid, however in clinical practice Büttiker criteria are widely used. The aim of this publication is to present the case of a newborn with bilateral congenital chylothorax with an updated review of the literature that encourages data collection and generation of national guidelines for standardized approach. This was a newborn preterm, who after a cesarean delivery presented respiratory distress syndrome who required early surfactant therapy achieving withdrawal of mechanical ventilation on his first day, with subsequent presentation of signs of respiratory distress, and a radiological and ultrasound finding of bilateral pleural effusion. Thoracentesis was performed obtaining cytochemical compatible with chylothorax. Again required invasive ventilatory support, closed bilateral thoracostomy and parenteral nutrition, with a satisfactory clinical course. MÉD.UIS. 2017;30(1):87-92.Keywords: Congenital Chylothorax. Respiratory Distress Syndrome, Newborn. Pleural Effusion. Premature.