Massive fetal chylothorax successfully treated with postnatal talc pleurodesis: A case report and review of the literature
Despite the rapid advances in fetal medicine and pediatric surgery, congenital chylothoraces have an associated mortality of 22–65% and an increased morbidity resulting from pulmonary hypoplasia, severe infections secondary to immune globulin deficiencies, protein malnutrition, and coagulopathy. Whi...
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| Format: | Article |
| Language: | English |
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Elsevier
2016-06-01
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| Series: | Journal of Pediatric Surgery Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213576615300671 |
| _version_ | 1818511406295678976 |
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| author | Maggie M. Hodges Timothy M. Crombleholme Mariana Meyers Ann Kulungowski Ahmed I. Marwan Taizo Nakano Nicholas Behrendt Kenneth W. Liechty |
| author_facet | Maggie M. Hodges Timothy M. Crombleholme Mariana Meyers Ann Kulungowski Ahmed I. Marwan Taizo Nakano Nicholas Behrendt Kenneth W. Liechty |
| author_sort | Maggie M. Hodges |
| collection | DOAJ |
| description | Despite the rapid advances in fetal medicine and pediatric surgery, congenital chylothoraces have an associated mortality of 22–65% and an increased morbidity resulting from pulmonary hypoplasia, severe infections secondary to immune globulin deficiencies, protein malnutrition, and coagulopathy. While the mainstay of therapy is medical management, large volume chylothoraces often require surgical management. In both the prenatal and postnatal periods, the recommended management of congenital chylothoraces is still controversial. We present a case of a prenatally diagnosed large chylothorax associated with a cervical lymphatic malformation. In our patient, the chylothorax persisted despite optimal postnatal medical management with drainage by tube thoracostomy, TPN, and octreotide. Adjuvant therapies included sirolimus and sclerotherapy directed toward the treatment of the macrocystic lymphatic malformation. We report the first case of a persistent congenital chylothorax associated with a lymphatic malformation successfully treated with thoracoscopic talc pleurodesis and sclerotherapy. |
| first_indexed | 2024-12-10T23:32:56Z |
| format | Article |
| id | doaj.art-a180994b386f45518f9be2b948529455 |
| institution | Directory Open Access Journal |
| issn | 2213-5766 |
| language | English |
| last_indexed | 2024-12-10T23:32:56Z |
| publishDate | 2016-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Case Reports |
| spelling | doaj.art-a180994b386f45518f9be2b9485294552022-12-22T01:29:18ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662016-06-019C1410.1016/j.epsc.2016.03.014Massive fetal chylothorax successfully treated with postnatal talc pleurodesis: A case report and review of the literatureMaggie M. Hodges0Timothy M. Crombleholme1Mariana Meyers2Ann Kulungowski3Ahmed I. Marwan4Taizo Nakano5Nicholas Behrendt6Kenneth W. Liechty7Colorado Fetal Care Center, Colorado Institute for Fetal & Maternal Health, Children's Hospital Colorado, Aurora, CO, USAColorado Fetal Care Center, Colorado Institute for Fetal & Maternal Health, Children's Hospital Colorado, Aurora, CO, USAColorado Fetal Care Center, Colorado Institute for Fetal & Maternal Health, Children's Hospital Colorado, Aurora, CO, USADivision of Pediatric Surgery, Children's Hospital Colorado, Aurora, CO, USAColorado Fetal Care Center, Colorado Institute for Fetal & Maternal Health, Children's Hospital Colorado, Aurora, CO, USACenter for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, CO, USAColorado Fetal Care Center, Colorado Institute for Fetal & Maternal Health, Children's Hospital Colorado, Aurora, CO, USAColorado Fetal Care Center, Colorado Institute for Fetal & Maternal Health, Children's Hospital Colorado, Aurora, CO, USADespite the rapid advances in fetal medicine and pediatric surgery, congenital chylothoraces have an associated mortality of 22–65% and an increased morbidity resulting from pulmonary hypoplasia, severe infections secondary to immune globulin deficiencies, protein malnutrition, and coagulopathy. While the mainstay of therapy is medical management, large volume chylothoraces often require surgical management. In both the prenatal and postnatal periods, the recommended management of congenital chylothoraces is still controversial. We present a case of a prenatally diagnosed large chylothorax associated with a cervical lymphatic malformation. In our patient, the chylothorax persisted despite optimal postnatal medical management with drainage by tube thoracostomy, TPN, and octreotide. Adjuvant therapies included sirolimus and sclerotherapy directed toward the treatment of the macrocystic lymphatic malformation. We report the first case of a persistent congenital chylothorax associated with a lymphatic malformation successfully treated with thoracoscopic talc pleurodesis and sclerotherapy.http://www.sciencedirect.com/science/article/pii/S2213576615300671Fetal pleural effusionCongenital chylothoraxTalc pleurodesisSurgical management |
| spellingShingle | Maggie M. Hodges Timothy M. Crombleholme Mariana Meyers Ann Kulungowski Ahmed I. Marwan Taizo Nakano Nicholas Behrendt Kenneth W. Liechty Massive fetal chylothorax successfully treated with postnatal talc pleurodesis: A case report and review of the literature Journal of Pediatric Surgery Case Reports Fetal pleural effusion Congenital chylothorax Talc pleurodesis Surgical management |
| title | Massive fetal chylothorax successfully treated with postnatal talc pleurodesis: A case report and review of the literature |
| title_full | Massive fetal chylothorax successfully treated with postnatal talc pleurodesis: A case report and review of the literature |
| title_fullStr | Massive fetal chylothorax successfully treated with postnatal talc pleurodesis: A case report and review of the literature |
| title_full_unstemmed | Massive fetal chylothorax successfully treated with postnatal talc pleurodesis: A case report and review of the literature |
| title_short | Massive fetal chylothorax successfully treated with postnatal talc pleurodesis: A case report and review of the literature |
| title_sort | massive fetal chylothorax successfully treated with postnatal talc pleurodesis a case report and review of the literature |
| topic | Fetal pleural effusion Congenital chylothorax Talc pleurodesis Surgical management |
| url | http://www.sciencedirect.com/science/article/pii/S2213576615300671 |
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