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Published on: March 12, 2019
Treatment of a persistent postoperative chylothorax with somatostatin
P C Rimensberger1, B Müller-Schenker, A Kalangos
1Department of Pediatrics, Hôpital des Enfants, University Hospital of Geneva, Switzerland. rimensberger-peter@hcuge.ch
Insights
A persistent chylothorax in an infant after heart surgery was successfully treated with somatostatin infusion. This treatment reduced chyle production, enabling early feeding and avoiding further surgery.
Area of Science:
- Pediatric Cardiac Surgery
- Thoracic Complications
- Gastroenterology
Background:
- Chylothorax is a rare, serious complication following pediatric cardiac operations.
- D-transposition of the great vessels requires complex surgical correction, such as the Senning procedure.
- Persistent chylothorax can lead to malnutrition and prolonged hospitalization.
Observation:
- A 4-month-old infant developed persistent chylothorax post-Senning procedure for D-transposition of the great vessels.
- Conservative management including 3 weeks of continuous drainage was ineffective.
- The infant required an alternative treatment to manage the chyle leak.
Findings:
- Continuous somatostatin infusion for 14 days effectively reduced and stopped chyle production.
- Somatostatin therapy facilitated the resumption of early enteral feeding.
- This non-surgical approach successfully resolved the chylothorax.
Implications:
- Somatostatin infusion represents a viable therapeutic option for managing persistent postoperative chylothorax in pediatric cardiac surgery patients.
- Early enteral feeding can be resumed, improving nutritional status and patient outcomes.
- This approach may prevent the need for further invasive surgical interventions.
Abstract:
Chylothorax is a rare but potentially serious complication of pediatric cardiac operations. We report the case of a 4-month-old boy who underwent a Senning procedure for correction of D-transposition of the great vessels. A persistent postoperative chylothorax developed, necessitating continuous drainage, despite conservative treatment over 3 weeks. Thereafter, continuous somatostatin infusion for 14 days led to the reduction and finally cessation of chyle production. This treatment allowed early enteral feeding and avoided further surgical intervention.
