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Bilateral chylothorax after severe vomiting in a child

Erdal Yekeler1, Hakki Ulutas

  • 1Department of Thoracic Surgery, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey. drerdalyekeler@hotmail.com

The Annals of Thoracic Surgery
|May 15, 2012
PubMed

Insights

Severe vomiting can cause bilateral chylothorax, a rare condition in children. This case highlights vomiting as a potential trigger for this serious respiratory condition in pediatric patients.

Area of Science:

  • Pediatric Pulmonology
  • Thoracic Surgery
  • Medical Case Reports

Background:

  • Chylothorax, characterized by lymphatic fluid in the pleural space, is typically caused by trauma or malignancy.
  • In pediatric cases, cardiothoracic surgery complications are the most frequent etiology of chylothorax.
  • Bilateral chylothorax is uncommon, often associated with idiopathic cases or increased intrathoracic pressure.

Observation:

  • A 9-year-old girl presented with dyspnea and back pain after severe vomiting.
  • Diagnosis revealed bilateral chylothorax, a rare presentation following forceful emesis.
  • No underlying pathology was identified besides the recent severe vomiting episode.

Findings:

  • The patient was diagnosed with bilateral chylothorax following severe vomiting.
  • Treatment involved bilateral chest tube insertion and left-sided pleurodesis.
  • The vomiting-induced intrathoracic pressure increase is the suspected cause.

Implications:

  • This case underscores severe vomiting as a potential, albeit rare, cause of bilateral chylothorax in children.
  • Highlights the importance of considering non-surgical etiologies in pediatric chylothorax.
  • Suggests further investigation into the mechanism linking forceful emesis to lymphatic disruption.

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