Congenital Chylothorax
Congenital Chylothorax (CC) is the accumulation of lymphatic fluid in the pleural space around the lungs. CC is usually a result of blockage of the thoracic duct during pregnancy. Infants with CC receiving regular formula feedings have persistent accumulations of fluid around the lungs because the production of lymphatic fluid is increased tenfold following regular formula feedings.
TREATMENT
Mechanical Ventilation to help the infant's lungs expand fully.
Thoracenteses which is removing the fluid from around the lungs.
Inserting a chest tube for drainage may be needed in some cases with respiratory distress.
Special Formulas (such as Enfaport) that consists of low-fat high-protein milk supplemented with MCT oil is used if the infant is able to take nutrition by mouth, or
IV nutrition combined with drainage of the space around the lungs is utilized.
Hopefully, with conservative treatment, the accumulation of fluid around the lungs resolves on its own, if not, surgical interventions will be considered.
SURGICAL CONSIDERATIONS
Surgical interventions might be considered if the chylothorax does not resolve or becomes worse. Surgical interventions are not risk free and not always successful, especially when associated with a malformed thoracic duct or a thoracic duct that does not function properly, or if infection is involved.
