P639 Management of congenital chylothorax in intensive neonatal care unit in sfax (tunisia). (June 2019)

• Record Type: Journal Article
• Authors: Hmed, Amel Ben; Thabet, Afef Ben; Regaieg, Chiraz; Charfi, Manel; Bouraoui, Amira; Hmida, Nedia; Regaieg, Ridha; Bouraoui, Amira; Gargouri, Abdellatif
• Is Part Of: Archives of disease in childhood. Volume 104:Supplement 3(2019)
• Page Start: A405
• Page End: A406
• Publication Date: 2019-06
• Subjects: Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild-2019-epa.970
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Background: Congenital chylothorax (cc) is a rare condition. It consists on an accumulation of the chyle in the pleural cavity. It is associated with significant morbidities including respiratory distress, malnutrition, immunodeficiency and infections. The treatment of congenital chylothorax is still not well codified. We have focused on postnatal management and after review of the literature we propose an algorithm of the treatment of congenital chylothorax. Methods: We report five cases of congenital chylothorax admitted to our neonatal intensive care unit between 2010 and 2018. Results: There were 3 males and two females. Prenatal diagnosis was made in 4 cases. There were 4 full's term newborns and one near term of 36 weeks. Pleural effusion was on the right side in three cases, on the left side in one case and bilateral in one case. Four cases required mechanical ventilation. Somatostatin was indicated in one case. The treatement was successful in four cases. One case presented a dysmorphic syndrome was died by pneumothoracis. Conclusions: The treatment of congenital chylothorax is based on conservative management. Somatostatin or its analog octreotide are considered as an adjunctive treatement of congenital chylothorax. However, the refractory cases are treated with chemical pleurodenis or surgical treatment. We propose an algorithm of the treatment of congenital chylothorax after review of the literature.