Chylothorax: Diagnosis and management in children

Paediatric Respiratory Reviews

Volumn 10, Issue 4, 2009, Pages 199-207

  Soto Martinez, Manuel ^a,b   Massie, John ^a,b,c  

^a ROYAL CHILDREN'S HOSPITAL   (Australia)

^b MURDOCH CHILDREN'S RESEARCH INSTITUTE   (Australia)

^c UNIVERSITY OF MELBOURNE   (Australia)

Author keywords

Children; Chylothorax; Chylous effusion; Lymphatic malformations; Octreotide; Pleural effusion; Somatostatin; Thoracic duct

Indexed keywords

CHILD; CHYLOTHORAX; DIFFERENTIAL DIAGNOSIS; HUMAN; REVIEW;

CHILD; CHYLOTHORAX; DIAGNOSIS, DIFFERENTIAL; HUMANS;

EID: 76549104090     PISSN: 15260542     EISSN: 15260550     Source Type: Journal    
DOI: 10.1016/j.prrv.2009.06.008     Document Type: Review

References (84)

1. Hillerdal G. Chylothorax and pseudochylothorax. Eur. Respir. J. 1997, 10:1157-1162.
2. Beghetti M., La Scala G., Belli D., Bugmann P., Kalangos A., Le Coultre C. Etiology and management of pediatric chylothorax. J. Pediatr. 2000, 136:653-658.
3. Buttiker V., Fanconi S., Burger R. Chylothorax in children: guidelines for diagnosis and management. Chest 1999, 116:682-687.
4. Romero S. Nontraumatic chylothorax. Curr. Opin. Pulm. Med. 2000, 6:287-291.
5. Van Pernis P. Variations of the thoracic duct. Surgery 1949, 26:806-809.
6. Merrigan B.A., Winter D.C., O'Sullivan G.C. Chylothorax. Br. J. Surg. 1997, 84:15-20.
7. Ross J.K. A review of the surgery of the thoracic duct. Thorax 1961, 16:12-21.
8. Kinnaert P. Anatomical variations of the cervical portion of the thoracic duct in man. J. Anat. 1973, 115:45-52.
9. Soto-Martinez M.E., Clifford V., Clarnette T., Ranganathan S., Massie R.J. Spontaneous chylothorax in a 2-year-old child. Med. J. Aust. 2009, 190:262-264.
10. Garcia Restoy E., Bella Cueto F., Espejo Arenas E., Aloy Duch A. Spontaneous bilateral chylothorax: uniform features of a rare condition. Eur. Respir. J. 1988, 1:872-873.
11. Paes M.L., Powell H. Chylothorax: an update. Br. J. Hosp. Med. 1994, 51:482-490.
12. Bach A.C., Babayan V.K. Medium-chain triglycerides: an update. Am. J. Clin. Nutr. 1982, 36:950-962.
13. Seaton T.B., Welle S.L., Warenko M.K., Campbell R.G. Thermic effect of medium-chain and long-chain triglycerides in man. Am. J. Clin. Nutr. 1986, 44:630-634.
14. St-Onge M.-P., Jones P.J.H. Physiological effects of medium-chain triglycerides: potential agents in the prevention of obesity. J. Nutr. 2002, 132:329-332.
15. Doerr C.H., Miller D.L., Ryu J.H. Chylothorax. Seminars in Respiratory and Critical Care Medicine 2001, 22:617-626.
16. Browse N.L., Allen D.R., Wilson N.M. Management of chylothorax. Br. J. Surg. 1997, 84:1711-1716.
17. Staats B.A., Ellefson R.D., Budahn L.L., Dines D.E., Prakash U.B., Offord K. The lipoprotein profile of chylous and nonchylous pleural effusions. Mayo Clin. Proc. 1980, 55:700-704.
18. Agrawal V., Sahn S.A. Lipid pleural effusions. Am. J. Med. Sci. 2008, 335:16-20.
19. Agrawal V., Doelken P., Sahn S.A. Pleural fluid analysis in chylous pleural effusion. Chest 2008, 133:1436-1441.
20. van Straaten H.L., Gerards L.J., Krediet T.G. Chylothorax in the neonatal period. Eur. J. Pediatr. 1993, 152:2-5.
21. Chan D.K., Ho N.K. Noonan syndrome with spontaneous chylothorax at birth. Aust. Paediatr. J. 1989, 25:296-298.
22. Van Aerde J., Campbell A.N., Smyth J.A., Lloyd D., Bryan M.H. Spontaneous chylothorax in newborns. Am. J. Dis. Child. 1984, 138:961-964.
23. Rocha G. Pleural effusions in the neonate. Curr. Opin. Pulm. Med. 2007, 13:305-311.
24. Dubin P.J., King I.N., Gallagher P.G. Congenital chylothorax. Curr. Opin. Pediatr. 2000, 12:505-509.
25. Sardet A. [Chylothorax in children and newborn infants]. Arch. Fr. Pediatr. 1981, 38:455.
26. Zito L., Keszler M. Massive edema and bilateral pleural effusions in a newborn infant. Ann. Allergy 1989, 63:277-280.
27. Dendale J., Comet P., Amram D., Lesbros D. [Prenatal diagnosis of chylothorax]. Arch. Pediatr. 1999, 6:867-871.
28. Randolph J.G., Gross R.E. Congenital chylothorax. Arch. Surg. 1957, 74:405.
29. Chernick V., Reed M.H. Pneumothorax and chylothorax in the neonatal period. J. Pediatr. 1970, 76:624-632.
30. Faul J.L., Berry G.J., Colby T.V., Ruoss S.J., Walter M.B., Rosen G.D., et al. Thoracic lymphangiomas, lymphangiectasis, lymphangiomatosis, and lymphatic dysplasia syndrome. Am. J. Respir. Crit. Care Med. 2000, 161:1037-1046.
31. Huber A., Schranz D., Blaha I., Schmitt-Mechelke T., Schumacher R. Congenital pulmonary lymphangiectasia. Pediatr. Pulmonol. 1991, 10:310-313.
32. Johnstone D.W. Postoperative chylothorax. Chest Surg. Clin. N. Am. 2002, 12:597-603.
33. Panthongviriyakul C., Bines J.E. Post-operative chylothorax in children: an evidence-based management algorithm. J. Paediatr. Child Health 2008, 44:716-721.
34. Chan S-y, Lau W., Wong W.H.S., Cheng L-c, Chau A.K.T., Cheung Y-f. Chylothorax in children after congenital heart surgery.[see comment]. Ann. Thorac. Surg. 2006, 82:1650-1656.
35. Cannizzaro V., Frey B., Bernet-Buettiker V. The role of somatostatin in the treatment of persistent chylothorax in children. Eur. J. Cardiothorac. Surg. 2006, 30:49-53.
36. Worthington M.G., de Groot M., Gunning A.J., von Oppell U.O. Isolated thoracic duct injury after penetrating chest trauma. Ann. Thorac. Surg. 1995, 60:272-274.
37. Dhande V., Kattwinkel J., Alford B. Recurrent bilateral pleural effusions secondary to superior vena cava obstruction as a complication of central venous catheterization. Pediatrics 1983, 72:109-113.
38. Anderst J.D. Chylothorax and child abuse. Pediatr Crit Care Med 2007, 8:394-396.
39. Geismar S.L., Tilelli J.A., Campbell J.B., Chiaro J.J. Chylothorax as a manifestation of child abuse. Pediatr. Emerg. Care 1997, 13:386-389.
40. Guleserian K.J., Gilchrist B.F., Luks F.I., Wesselhoeft C.W., DeLuca F.G. Child abuse as a cause of traumatic chylothorax. J. Pediatr. Surg. 1996, 31:1696-1697.
41. Thurer R.J. Chylothorax: a complication of subclavian vein catheterization and parenteral hyperalimentation. J. Thorac. Cardiovasc. Surg. 1976, 71:465-468.
42. Ruggiero R.P., Caruso G. Chylothorax--a complication of subclavian vein catheterization. Jpen: Journal of Parenteral & Enteral Nutrition 1985, 9:750-753.
43. Connor F.L., Angelides S., Gibson M., Larden D.W., Roman M.R., Jones O., et al. Successful resection of localized intestinal lymphangiectasia post-Fontan: role of (99m)technetium-dextran scintigraphy. Pediatrics 2003, 112:e242-e247.
44. Van Veldhuizen P.J., Taylor S. Chylothorax: a complication of a left subclavian vein thrombosis. Am. J. Clin. Oncol. 1996, 19:99-101.
45. Chan E.H., Russell J.L., Williams W.G., Van Arsdell G.S., Coles J.G., McCrindle B.W. Postoperative chylothorax after cardiothoracic surgery in children.[see comment]. Ann. Thorac. Surg. 2005, 80:1864-1870.
46. Doerr C.H., Allen M.S., Nichols F.C., Ryu J.H. Etiology of chylothorax in 203 patients. [see comment]. Mayo Clin. Proc. 2005, 80:867-870.
47. Nair S.K., Petko M., Hayward M.P. Aetiology and management of chylothorax in adults. Eur. J. Cardiothorac. Surg. 2007, 32:362-369.
48. Easa D., Balaraman V., Ash K., Thompson B., Boychuk R. Congenital chylothorax and mediastinal neuroblastoma. J. Pediatr. Surg. 1991, 26:96-98.
49. Cakir E., Gocmen B., Uyan Z.S., Oktem S., Kiyan G., Karakoc F., et al. An unusual case of chylothorax complicating childhood tuberculosis. Pediatr. Pulmonol. 2008, 43:611-614.
50. Tutor J.D., Schoumacher R.A., Chesney P.J. Chylothorax associated with histoplasmosis in a child. Pediatr. Infect. Dis. J. 2000, 19:262-263.
51. Grobbelaar M., Andronikou S., Goussard P., Theron S., Mapukata A., George R. Chylothorax as a complication of pulmonary tuberculosis in children. Pediatr. Radiol. 2008, 38:224-226.
52. Cogar B.D., Groshong T.D., Turpin B.K., Guajardo J.R. Chylothorax in Henoch-Schonlein purpura: a case report and review of the literature. Pediatr. Pulmonol. 2005, 39:563-567.
53. Rocha G., Fernandes P., Rocha P., Quintas C., Martins T., Proenca E. Pleural effusions in the neonate. Acta Paediatr. 2006, 95:791-798.
54. Massie J., Pillarisetti N., Ranganathan S. No role for routine CT scans in paediatric empyemas. Thorax 2008, 63:1028-1029.
55. Sharma R., Wendt J.A., Rasmussen J.C., Adams K.E., Marshall M.V., Sevick-Muraca E.M. New horizons for imaging lymphatic function. Ann. N. Y. Acad. Sci. 2008, 1131:13-36.
56. Guermazi A., Brice P., Hennequin C., Sarfati E. Lymphography: an old technique retains its usefulness. Radiographics 2003, 23:1541-1558. discussion 1559-60.
57. Cerfolio R.J., Allen M.S., Deschamps C., Trastek V.F., Pairolero P.C. Postoperative chylothorax. J. Thorac. Cardiovasc. Surg. 1996, 112:1361-1365. discussion 1365-6.
58. Pui M.H., Yueh T.C. Lymphoscintigraphy in chyluria, chyloperitoneum and chylothorax. J. Nucl. Med. 1998, 39:1292-1296.
59. Bellini C., Boccardo F., Campisi C., Villa G., Taddei G., Traggiai C., et al. Lymphatic dysplasias in newborns and children: the role of lymphoscintigraphy. J. Pediatr. 2008, 152:587-589.
60. Ruehm S.G., Schroeder T., Debatin J.F. Interstitial MR lymphography with gadoterate meglumine: initial experience in humans. Radiology 2001, 220:816-821.
61. Clement O., Luciani A. Imaging the lymphatic system: possibilities and clinical applications. Eur. Radiol. 2004, 14:1498-1507.
62. Nguyen D.M., Shum-Tim D., Dobell A.R., Tchervenkov C.I. The management of chylothorax/chylopericardium following pediatric cardiac surgery: a 10-year experience. J. Card. Surg. 1995, 10:302-308.
63. Helin R.D., Angeles S.T.V., Bhat R. Octreotide therapy for chylothorax in infants and children: A brief review. [see comment]. Pediatr Crit Care Med 2006, 7:576-579.
64. Rosti L., De Battisti F., Butera G., Cirri S., Chessa M., Delogu A., et al. Octreotide in the management of postoperative chylothorax. Pediatr. Cardiol. 2005, 26:440-443.
65. Roehr C.C., Jung A., Proquitte H., Blankenstein O., Hammer H., Lakhoo K., et al. Somatostatin or octreotide as treatment options for chylothorax in young children: a systematic review. Intensive Care Med. 2006, 32:650-657.
66. Buettiker V., Hug M.I., Burger R., Baenziger O. Somatostatin: a new therapeutic option for the treatment of chylothorax. Intensive Care Med. 2001, 27:1083-1086.
67. Lam J.C.A., Sara, Tobias, Joseph D. Initial Experience with Octreotide in the Pediatric Population. Am. J. Ther. 2001, 8:409-415.
68. Kalomenidis I. Octreotide and chylothorax. Curr. Opin. Pulm. Med. 2006, 12:264-267.
69. Rosti L., Bini R.M., Chessa M., Butera G., Drago M., Carminati M. The effectiveness of octreotide in the treatment of post-operative chylothorax. Eur. J. Pediatr. 2002, 161:149-150.
70. Guillem P., Papachristos I., Peillon C., Triboulet J. Etilefrine use in the management of post-operative chyle leaks in thoracic surgery. Interact Cardiovasc Thorac Surg 2004, 3:156-160.
71. Graham D.D., McGahren E.D., Tribble C.G., Daniel T.M., Rodgers B.M. Use of video-assisted thoracic surgery in the treatment of chylothorax. Ann. Thorac. Surg. 1994, 57:1507-1511. discussion 1511-2.
72. Achildi O, Smith BP, Grewal H. Thoracoscopic Ligation of the Thoracic Duct in a Child with Spontaneous Chylothorax doi:10.1089/lap.2006.16.546. Journal of Laparoendoscopic & Advanced Surgical Techniques 2006; 16:546-549.
73. Robinson C.L. The management of chylothorax. Ann. Thorac. Surg. 1985, 39:90-95.
74. Platis I.E., Nwogu C.E. Chylothorax. Thorac Surg Clin 2006, 16:209-214.
75. Brissaud O., Desfrere L., Mohsen R., Fayon M., Demarquez J.L. Congenital idiopathic chylothorax in neonates: chemical pleurodesis with povidone-iodine (Betadine). [see comment]. Archives of Disease in Childhood Fetal & Neonatal Edition 2003, 88:F531-F533.
76. Noel A.A., Gloviczki P., Bender C.E., Whitley D., Stanson A.W., Deschamps C. Treatment of symptomatic primary chylous disorders. J. Vasc. Surg. 2001, 34:785-791.
77. Engum S.A., Rescorla F.J., West K.W., Scherer L.R., Grosfeld J.L. The use of pleuroperitoneal shunts in the management of persistent chylothorax in infants. J. Pediatr. Surg. 1999, 34:286-290.
78. Wolff A.B., Silen M.L., Kokoska E.R., Rodgers B.M. Treatment of refractory chylothorax with externalized pleuroperitoneal shunts in children. Ann. Thorac. Surg. 1999, 68:1053-1057.
79. Cope C. Management of chylothorax via percutaneous embolization. Curr. Opin. Pulm. Med. 2004, 10:311-314.
80. Jorgensen C., Brocks V., Bang J., Jorgensen F.S., Ronsbro L. Treatment of severe fetal chylothorax associated with pronounced hydrops with intrapleural injection of OK-432. Ultrasound Obstet. Gynecol. 2003, 21:66-69.
81. Rostom A.Y. Treatment of thoracic lymphangiomatosis. Arch. Dis. Child. 2000, 83:138-139.
82. Bernet-Buettiker V., Waldvogel K., Cannizzaro V., Albisetti M. Antithrombin activity in children with chylothorax. Eur. J. Cardiothorac. Surg. 2006, 29:406-409.
83. Wasmuth-Pietzuch A., Hansmann M., Bartmann P., Heep A. Congenital chylothorax: lymphopenia and high risk of neonatal infections. Acta Paediatr. 2004, 93:220-224.
84. Orange J.S., Geha R.S., Bonilla F.A. Acute chylothorax in children: selective retention of memory T cells and natural killer cells. J. Pediatr. 2003, 143:243-249.