Congenital chylothorax in infants: An updated scoping review

A Alghobaishi1,2, S I Albraim3, H I Albraim3

  • 1Pediatric Critical Care, Department of Pediatric Medicine, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.

Insights

Congenital chylothorax (CCT) in newborns involves lymphatic fluid buildup in the chest, causing respiratory distress. Early diagnosis and multidisciplinary management, including drainage and nutritional support, are key to improving infant outcomes.

Area of Science:

  • Neonatal Medicine
  • Pediatric Surgery
  • Thoracic Surgery

Background:

  • Congenital chylothorax (CCT) is a rare neonatal condition characterized by lymphatic fluid accumulation in the pleural cavity.
  • It is the primary cause of pleural effusion in infants, leading to respiratory distress due to fluid buildup between the lungs and chest wall.
  • CCT arises from idiopathic abnormalities in the thoracic duct.

Purpose of the Study:

  • To review current concepts in the etiology, diagnosis, and treatment of congenital chylothorax in newborns.
  • To emphasize the importance of timely diagnosis and a multidisciplinary approach for managing CCT.
  • To integrate evidence on emerging diagnostic and treatment strategies for CCT.

Main Methods:

  • A comprehensive scoping review of published studies from 1980 to January 2024.
  • Literature search conducted across reputable databases including Google Scholar, PubMed, Springer, and BioMed Central.
  • Synthesis of evidence on diagnostic tools like lymphangiography and lymphoscintigraphy, and treatments such as video-assisted thoracoscopic surgery.

Main Results:

  • Timely pleural fluid drainage is essential for alleviating respiratory distress and preventing complications.
  • Appropriate nutritional care is critical for supporting overall neonatal health and recovery.
  • Early intervention and continuous monitoring significantly improve the likelihood of positive outcomes in infants with CCT.

Conclusions:

  • Early management and tailored interventions are crucial for improving outcomes in infants with congenital chylothorax.
  • Advancements in management strategies have led to improvements in morbidity and mortality rates.
  • A multidisciplinary strategy integrating new diagnostic and therapeutic options is vital for optimal CCT care.
Abstract

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