Neonatal chylothorax

Abstract

Introduction: congenital chylothorax is a rare respiratory condition, however it is the most frequent cause of pleural effusion in newborns. Its incidence is low, approximately 1:10 000-15 000 live births. Treatment proposals include conservative, drug and surgical options.

Objective: to present the case of a newborn with congenital chylothorax treated with suspension of oral feeding and parenteral administration of medium chain aminoacids and short or medium chain fatty acids upon reinitiation of enteral feeding.

Case presentation: male patient, first preterm twins and low weight, with parabiotic syndrome. At 21 days of life he presented left pleural effusion. It was punctured and the study of drained fluid showed characteristics of chylothorax. Conservative treatment was indicated, with complete parenteral feeding, and later with milk rich in fatty acids of short and medium chains. Once recovered, he was discharged from hospital.

Conclusions: in the presence of a neonate presenting clinical and radiological signs of pleural effusion, the possibility of a chylothorax should be considered, so it is essential to evacuate the fluid for study. Once the diagnosis is confirmed, it is suggested to suspend the oral feeding and administer medium chain amino acids parenterally. The restart of enteral feeding should be with short or medium chain fatty acids, without long-chain fatty acids, to avoid recurrence