Surgical Disorders of the Chest and Airways

Keller, B; Hirose, Shinjiro; Farmer, Diana L.

doi:10.1016/b978-0-323-40139-5.00049-8

Cited by 2 publications

(6 citation statements)

References 382 publications

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“…Therefore, we used temporary external pacemaker at birth and attempted to reduce chylous effusion first. Appropriate treatment for chylothorax such as total parenteral nutrition, 2 octreotide, 2 prednisolone, 13 and coagulation factor XIII 14 was effective with a subsequent satisfactory course. Total parenteral nutrition and octreotide may serve to decrease lymphatic flow.…”

Section: Discussionmentioning

confidence: 96%

“… 2 Among neonates, chylothorax can be distinguished from pleural transudate and pleural exudate by the leukocyte count in pleural effusion is >1,000/μL 2 with a lymphocyte fraction above 80%, 2 and elevated triglyceride levels in the pleural effusion above 100 to 110 mg/dL or above levels detected in serum; however, triglycerides are not present unless enteral feeds are initiated. 2 It is also informative if the pleural effusion is milk-colored, with total protein levels higher than 2.5 g/dL, 6 a P/S ratio of IgG > 0.60, 7 and LDH levels higher than 110 IU/L. 2 6 …”

Section: Discussionmentioning

confidence: 99%

“… 2 It is also informative if the pleural effusion is milk-colored, with total protein levels higher than 2.5 g/dL, 6 a P/S ratio of IgG > 0.60, 7 and LDH levels higher than 110 IU/L. 2 6 …”

Section: Discussionmentioning

confidence: 99%

“…The relationship between CCAVB and chylothorax has not been clarified. Chylothorax can be the result of a surgical procedure, such as open-heart surgery, that results in injury to the thoracic duct, 2 but it is unlikely to be caused by temporary pacemaker placement in a procedure limited to the anterior thorax. Although it is possible that these two rare diseases occurred together by coincidence, a causal relationship may be considered:…”

Section: Discussionmentioning

confidence: 99%

“…1 Congenital chylothorax results from the accumulation of lymphatic fluid in the thoracic cavity; this disorder is reported in 1/10,000 to 15,000 live births. 2 CCAVB can be complicated by transudative pleural effusion or hydrops fetalis resulting from cardiac failure secondary to bradycardia. CCAVB diagnosed in association with chylothorax is an extremely rare event and has been reported in only one case with trisomy 21 previously.…”

mentioning

confidence: 99%

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Chylothorax Associated with Congenital Complete Atrioventricular Block

Fujino

Maruyama

Tsukamoto

et al. 2020

AJP Rep

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Introduction Congenital complete atrioventricular block (CCAVB) associated with congenital chylothorax is a rare finding that has been reported in only one case in the literature. We report here the case of an infant with CCAVB complicated by congenital chylothorax. Patient Report We present the case of a male neonate with a birth weight of 2114 g. Fetal bradycardia and right pleural effusion were detected at gestational age of 22 weeks. Maternal serum levels of anti-Sjögren's-syndrome-related antigen A autoantibody were high (4840 U/mL). The neonate was delivered at gestational age of 33 weeks; a temporary external pacemaker was placed immediately after birth that resulted in an improved cardiac output. Milk-colored pleural effusion increased in volume together with the initiation of breast milk feeding. Lymphocytosis and high triglyceride levels in the pleural fluid led to the diagnosis of chylothorax. The pleural effusion resolved in response to prednisolone, octreotide, and total parenteral nutrition. Discussion The causal relationship between CCAVB and congenital chylothorax can be explained by considering the damage to the lymphatic vessels secondary to inflammation due to maternal autoantibodies and venous congestion due to bradycardia. Conclusion In any case of CCAVB associated with atypical pleural effusion, one must consider the possibility of congenital chylothorax.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

“… 2 It is also informative if the pleural effusion is milk-colored, with total protein levels higher than 2.5 g/dL, 6 a P/S ratio of IgG > 0.60, 7 and LDH levels higher than 110 IU/L. 2 6 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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