Abstract
Chylothorax—the collection of lymphatic fluid in the pleural space—is a rare finding in otherwise healthy adolescents. Initially, clinical signs and symptoms are often non-specific and a wide range of underlying causes necessitates extensive diagnostic workup. Treatment options include dietary measures, medical treatment, and various surgical procedures. We report about a 12-year-old boy with accidental diagnosis of chylothorax. Lymphatic imaging led to visualization of a leakage of an accessory left-sided thoracic duct and thoracoscopic clipping was successfully performed. Lymphatic imaging procedures depict underlying causes of chylothorax allowing targeted therapeutic management.
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References
Tutor JD. Chylothorax in infants and children. Pediatrics. 2014;133:722–33.
Costa KM, Saxena AK. Surgical chylothorax in neonates: management and outcomes. World J Pediatr. 2018;14:110–5. https://doi.org/10.1007/s12519-018-0134-x.
Faul JL, Berry GJ, Colby TV, et al. Thoracic lymphangiomas, lymphangiectasis, lymphangiomatosis, and lymphatic dysplasia syndrome. Am J Respir Crit Care Med. 2000;161:1037–46.
Yekeler E, Ulutas H. Bilateral chylothorax after severe vomiting in a child. Ann Thorac Surg. 2012;94:e21–3.
Mery CM, Moffett BS, Khan MS, et al. Incidence and treatment of chylothorax after cardiac surgery in children: analysis of a large multi-institution database. J Thorac Cardiovasc Surg. 2014;147:678–86.e1.
Kreutzer J, Kreutzer C. Lymphodynamics in congenital heart disease: The Forgotten Circulation. J Am Coll Cardiol. 2017;69:2423–7.
Chavhan GB, Amaral JG, Temple M, Itkin M. MR lymphangiography in children: technique and potential applications. Radiographics. 2017;37:1775–90.
Paul S, Altorki NK, Port JL, Stiles BM, Lee PC. Surgical management of chylothorax. Thorac Cardiovasc Surg. 2009;57:226–8.
Haines C, Walsh B, Fletcher M, Davis PJ. Chylothorax development in infants and children in the UK. Arch Dis Child. 2014;99:724–30.
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Kargl, S., Maier-Hiebl, B. Pediatric chylothorax—lymphatic imaging enables targeted surgical treatment. Indian J Thorac Cardiovasc Surg 35, 233–236 (2019). https://doi.org/10.1007/s12055-018-00779-7
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DOI: https://doi.org/10.1007/s12055-018-00779-7