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Bilateral chylothorax.

P Cooper1, M L Paes

  • 1Department of Cardiothoracic Anaesthesia, Freeman Hospital, Newcastle upon Tyne.

British Journal of Anaesthesia
|March 1, 1991
PubMed
Summary
This summary is machine-generated.

This study reports a rare case of bilateral chylothoraces in an infant following aortic coarctation repair. Surgical intervention for chyle leakage led to a subsequent complication of brawny edema.

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Area of Science:

  • Pediatric Surgery
  • Cardiovascular Surgery
  • Thoracic Surgery

Background:

  • Coarctation of the aorta is a congenital heart defect requiring surgical correction.
  • Chylothorax, the accumulation of chyle in the pleural space, can be a rare complication post-cardiac surgery.
  • Management of pediatric chylothorax involves conservative measures and surgical intervention.

Observation:

  • A 2.5-kg infant developed bilateral chylothoraces 10 days after coarctation of the aorta repair.
  • Initial conservative management (ventilation, drainage, enteral feeding) failed to control significant chyle loss.
  • Surgical ligation of the thoracic duct and pleurectomy were performed due to massive chyle loss.

Findings:

  • Post-operative thoracic duct ligation resulted in rapid brawny edema of the right upper quadrant.

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  • Resolution of the edema required a subsequent period of conservative treatment.
  • Massive chyle loss, nearly three times the child's blood volume, necessitated aggressive management.

    • Implications:

    • This case highlights a significant iatrogenic complication following thoracic duct ligation for refractory chylothorax.
    • Understanding fluid and nutritional losses is critical in managing pediatric chylothorax.
    • Reviewing the literature aids in managing rare post-surgical complications in pediatric cardiovascular surgery.