All issues > Volume 51(11); 2008

Original Article

Korean J Pediatr. 2008;51(11):1172-1178. Published online November 15, 2008.

A clinical study of congenital chylothorax and octreotide therapy

Ung Geon UG Oh¹, Kyoung Eun KE Choi¹, Kyung Ah KA Kim¹, Sun Young SY Ko¹, Yeon Kyung YK Lee¹, Son Moon SM Shin¹

¹Department of Pediatrics, Cheil General Hospital & Women`s Healthcare Center, Kwandong University College of Medicine, Seoul, Korea

Correspondence Kyung Ah KA Kim ,Email: kkaped@medimail.co.kr

Abstract

Purpose
: Congenital chylothorax is an accumulation of lymphatic fluid within the pleural space. It is a common cause of unidentified hydrops fetalis. We examined the perinatal history, clinical manifestation, diagnosis, treatment, and outcome in 6 newborns diagnosed to have congenital chylothorax with hydrops fetalis. We also studied the effect of octreotide therapy for congenital chylothorax in relation to conservative treatment.
Methods
: We retrospectively reviewed the medical records of 6 patients diagnosed to have congenital chylothorax with hydrops fetalis among 27,907 newborns who were born at the Cheil General Hospital and Womens Healthcare Center between January 2004 and July 2007. The diagnosis of chylothorax is based on the analysis of pleural fluid before and after milk feeding.
Results
: Incidence of congenital chylothorax in this study was 0.021%. All 6 cases were noted in over the 92% lymphocyte in pleural analysis. Transudate was changed into chyle with increasing triglyceride levels above 200 mg/dL after milk feeding. Three of 6 infants improved with conservative treatment, including thoracostomy and assisted ventilation. The others had persistent symptoms despite conservative treatment and responded to octreotide therapy. A complication, specifically vomiting was noted in 1 case during octreotide therapy.
Conclusion
: In this study, octreotide therapy resulted in a safe and excellent outcome. Therefore, octreotide therapy is considered in severe refractory congenital chylothorax in conservative treatment. Further studies are required to determine appropriate guidelines for octreotide therapy.

Keywords :Congenital chylothorax, Octreotide, Hydrops fetalis, Clinical study