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Bilateral spontaneous chylothorax after severe vomiting in children
Antonio Lucas Lima Rodrigues1, Mariana Tresoldi das Neves Romaneli2, Celso Dario Ramos2
1Hospital de Clínicas da Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil.
Summary
Severe vomiting can cause bilateral chylothorax in children due to thoracic duct injury. This rare cause of pleural effusion highlights the importance of considering vomiting-induced pressure changes.
Area of Science:
- Pediatric Medicine
- Thoracic Surgery
- Medical Case Reports
Background:
- Chylothorax, accumulation of lymphatic fluid in the pleural space, is uncommon in children outside the neonatal period.
- Established causes include trauma, malignancy, infection, and inflammatory conditions.
Observation:
- A 7-year-old girl presented with chronic facial swelling following severe vomiting (hyperemesis).
- She subsequently developed bilateral pleural effusion containing chylous fluid, confirmed via thoracentesis.
- Investigations revealed the chylothorax was secondary to thoracic duct injury.
Findings:
- The thoracic duct injury was attributed to increased intrathoracic pressure from severe vomiting.
- Lymphoscintigraphy supported the diagnosis of thoracic duct injury as the etiology.
- This specific cause of pediatric chylothorax is infrequently documented in medical literature.
Implications:
- This case expands the known etiologies of pediatric chylothorax.
- Clinicians should consider thoracic duct injury secondary to vomiting-induced pressure as a potential cause in pediatric pleural effusions.
- Further research may be warranted to understand this rare complication.
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