• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1172-1178
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• 2008

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.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.17 no.1
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• pp.24-30
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• 2017

Gorham-Stout disease is a rare disorder characterized by lymphovascular proliferation and destruction of osseous matrix. The etiology of this condition remains poorly understood. Chylothorax as a consequence of lymphatic leakage in thoracic cage may cause a severe life-threatening complication, accompanying respiratory difficulty. Currently, there is no standard management for this extremely rare condition. Here we describe a patient affected by Gorham-Stout disease successfully managed by the combined treatment of mTOR inhibitor and beta-blocker. A previously healthy 11-year-old female developed dyspnea and chest pain with a massive pleural effusion. The ligation of right thoracic duct and bilateral pleurodesis temporarily decreased her pleural effusion, which was aggravated repetitively and required frequent admission and tube thoracotomies. Along with bilateral pleural adhesiolysis with thoracotomy, the combined treatment of oral beta-blocker and mTOR inhibitor was commenced. After 1 month of oral medication, her pleural effusion was not increased and she was free of respiratory difficulty on room air without chest tubes. Over eleven months of treatment, no serious adverse reaction was noted and her condition has been stable with no further admission required.

• Journal of Chest Surgery
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• v.37 no.5
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• pp.456-459
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• 2004

A 16 month old male infant was found with slip down state in a bath room without evidence of trauma to whole body. The infant was treated with several thoracentesis and closed drainage due to persistent right pleural effusion at other hospital and transferred to our hospital for further evaluation and treatment at July 2003. The pleural effusion was confirmed as chylothorax by chemical analysis. He was treated with parenteral feeding for 21 days. Because the amount of chest tube drainage was about 110∼210 cc/day, and could not be decreased with conservative treatment. patients underwent ligation of thoracic duct. Post-operative course was uneventful except post-op. empyema thoracis, The open drainage tube was removed at post operative 30 days, The patient was in very good condition with complete cure until post-operative 3 months.

• Tuberculosis and Respiratory Diseases
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• v.57 no.4
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• pp.377-380
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• 2004

We report a rare case of idiopathic chylothorax and chyluria. A 31 year-old woman was referred to our hospital with a right-sided pleural effusion. Cream-colored pleural fluid and urine were confirmed as chylothorax and chyluria, respectively, by a lipoprotein electrophoresis. Even though she had previously underwent surgery for pelvic fibrosarcoma and experienced its recurrence, there has been no change of mass size and no evidence of thoracic duct or urinary tract obstruction as of the moment. Hence, idiopathic chylothorax and chyluira was diagnosed. Because she responded poorly to conservative treatment, thoracic duct ligation and pleurodesis were performend ; wherease chyluria was resolved spontaneously.

• Journal of Chest Surgery
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• v.29 no.6
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• pp.672-674
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• 1996

Chylothorax is a rare, but well-recognized complication of cardiothoracic surgery and operations in the region of the esophageal or aortic diaphragmatic hiatus. Especially, in nutritionally depleted patients requiring esophagectomy for benign or malignant diseases, it is a potentially life-threatening disorder that has profound respiratory, nutritional and immunologic co sequences . We have experienced a case of chylothorax after transhiatal esophagectomy in benign esophageal stricture. The diagnosis of chylothorax was confirmed after feeding through the jejunostomy tube by the change of the character of pleural effusion and high triglyceride level on the 5th postoperative day. On the thirteenth postoperative day, supradiaphragmatic thoracic duct ligation was performed through right thoracotomy. We could remove the chest tube on the 22th postoperative day, and the patient is being followed-up at out patient clinic without complications.

• Korean Journal of Head & Neck Oncology
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• v.22 no.2
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• pp.179-182
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• 2006

Bilateral chylothorax as a complication of radical neck dissection is extremely rare. Early diagnosis of chylothorax is important due to the consequences on metabolic & cardiopulmonary conditions. This present report describes our recent experiences with two cases of bilateral chylothorax following left modified radical neck dissection that was treated successfully by conservative management.

• 대한두경부종양학회:학술대회논문집
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• 1994.11a
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• pp.25.1-25.1
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• 1994

• Journal of Chest Surgery
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• v.29 no.3
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• pp.360-364
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• 1996

Chylothorax is denned by extravasation of the milky fluid to pleural cavity from the thoracic duct or it's main branches due to operative trauma, congenital lesions, diagnostic procedures, tumor, etc. Another rare cause is diffuse pulmonary Iymphangiomatosis which is uncommon and not well charact rized. We experienced a case of the bilateral chylothorax caused by the diffuse pulmonary Iymphangiomatosis. The patient was at years old girl with symptoms of coughing and febrile sensation, and the chest radiographs showed bilateral pleural effusion and interstitial infiltrates. The laboratory data of the pleural effusion was identified as chile. Uncontrollable with closed tube thoracostomy, division of tHe thoracic duct and biopsy were decided. Biopsy showed anastomosing endothelial lined spaces along the pulmonary Iymphatic routes especially in pleural and interlobar septum, and smooth muscle at the proliferative interstitium of the Iymphatic duct was observed. Postoperatively, chylothorax was controlled with several trial of chemical pleurodesis. Af'leer discharge from the hospital, she was well for ten months follow up.

• Tuberculosis and Respiratory Diseases
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• v.45 no.5
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• pp.1082-1086
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• 1998

Chylothorax is a debilitating condition to the point of threatening life. Diagnosis and subsequent management present significant problems for the clinician, and the adverse effects of chyle loss on nutrition status and immune function result in devastating consequences for the patient, propmpt diagnosis is essential to institute an effective therapeutic regimen. we reported a patient of idiopathic bilateral chylothorax treated by conservative approach with review of literatures.

• Tuberculosis and Respiratory Diseases
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• v.62 no.6
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• pp.554-559
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• 2007

A 29-year-old female patient presented with exertional dyspnea that she had suffered with for 2 months. The chest X-ray displayed right pleural effusion that was diagnosed as chyle, according to the level of cholesterol and triglyceride in the pleural fluid. VATS (video assisted thoracic surgery) of the right lung was performed on the 7th day of hospitalization for obtaining a lung biopsy and to control the of pneumochylothorax. On the 11th hospitalization day, VATS of left lung was also performed to control the recurrent pneumothorax via pleurodesis. The lung biopsy showed moderate amounts of spindle-shaped and rounded cells (so-called LAM cells), which were reactive to actin and HMB45 (on immunohistochemical stains). We report here on a rare case of lymphangioleiomyomatosis combined with chylothorax and bilateral pneumothroraces.