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Congenital Chylothorax


Presentation

  • Chylothorax presenting as non-immune hydrops is even rarer. We report a case of congenital bilateral chylothorax presenting as non immune hydrops and managed successfully with chemical pleurodesis.[ncbi.nlm.nih.gov]
Soft Tissue Swelling
  • Right lateral soft tissue swelling secondary to chylous leakage. Physical exam revealed posteriorly rotated ears, down-slanted palpebral fissures, redundant neck skin, and a fluctuant mass on the right side of the chest.[nature.com]
Skin Lesion
  • Local cytotoxic mucosal and skin lesions have been described. 19 The only adverse effect that we considered to be possibly related to the treatment was generalised oedema, which occurred 24 hours after povidone-iodine instillation in case 3.[fn.bmj.com]
Generalized Seizure
  • The patient developed generalized seizure in the first hour which was controlled by phenobarbitone. Babygraph of the patient showing generalized edema, ascites and massive bilateral pleural effusion.[ncbi.nlm.nih.gov]

Workup

  • Conversely, increasing levels indicate a worsening condition requiring aggressive workup or treatment. LD iso enzyme analysis may be helpful in diagnosing problematic exudates but is not routinely recommended (Lossos, 1997).[passeidireto.com]
  • Diagnostic workup in a neonate presenting with chylothorax would be maternal, fetal, and neonatal. The aim is to exclude other causes of hydrothoraces.[ispub.com]

Treatment

  • […] group B of patients who needed both medical and surgical treatment (pleural abrasion and/or pleurectomy).[ncbi.nlm.nih.gov]

Prognosis

  • Morbidity of congenital chylothorax (CC) is high, and prognosis is very poor if chylothorax is associated with hydrops fetalis. The optimal treatment of CC has not been defined.[ncbi.nlm.nih.gov]

Etiology

  • Excluding all known forms of eosinophilic pulmonary disease either histologically or clinically, possible mechanisms of its etiology are discussed.[ncbi.nlm.nih.gov]

Epidemiology

  • Congenital chylothorax: a prospective nationwide epidemiological study in Germany. Arch Dis Child - Fetal Neonatal Ed [Internet]. 2015;100(2):F169– 72. Available from: archdischild-2014-307274. 4. Rocha G. Pleural effusions in the neonate.[revistas.uis.edu.co]
  • . , 1 Jan 2019 , In : Epidemiology (Cambridge, Mass.). 30 , 1 , p. 38-47 10 p.[monash.edu]
  • Declarations Authors’ Affiliations (1) Department of Congenital Heart Disease, University of Freiburg, Mathildenstraße 1, 79106 Freiburg, Germany (2) Institute for Epidemiology and Biometrics, University of Freiburg, Stefan-Meier-Straße 26, 79106 Freiburg[cardiothoracicsurgery.biomedcentral.com]
  • The severity of the complications depend on how fast the chylothorax accumulated, how big it was, and how chronic it was. [9] Epidemiology [ edit ] This disease is rare and usually is a complication of surgeries in the neck and mediastinium.[en.wikipedia.org]
Sex distribution
Age distribution

Pathophysiology

  • Autopsy findings from one of these cases and others previously described suggest that the pathophysiological mechanisms involved may be variable.[ncbi.nlm.nih.gov]
  • This review aims to summarize the current literature regarding pathophysiology, clinical manifestations, and management options for CC.[dovepress.com]
  • Pathogenesis: The main causes of fistula Chile are effusion thoracic duct obstruction at different levels or channel its repercussions on waging tributarelor pathophysiological mechanisms depending on the level where it appears.[medicaldb.blogspot.com]
  • Our observation that chylothorax is associated with secondary chest closure supports the thesis that non-specific mediastinal (lymphatic) tissue damage and postoperative impaired hemodynamics should be considered as important factors in the pathophysiology[cardiothoracicsurgery.biomedcentral.com]
  • Pathophysiology Primary Form: Folds are symmetrical, with normal histology or hypertrophy and hyperplasia of connective tissue or epidermal appendages (25); it develops mainly in puberty.[scielo.org.co]

Prevention

  • Pulmonary hypoplasia was successfully prevented by OK-432.[ncbi.nlm.nih.gov]
  • Page 223 - American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med 2003;167:603-662. ‎[books.google.com]
  • It prevented our patient from undergoing reinsertion of chest tubes or surgery.[jcnonweb.com]

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