Conservative Treatment of postoperative chylothorax in pediatric patients (in Spanish)

Abstract

INTRODUCTION. Chylothorax results from damage to the thoracic duct due to rupture, laceration, tear, or compression. It is frequent as a complication after cardiothoracic surgery. The basis of treatment has been based on: initial drainage, diet modification, use of synthetic somatostatin or analog (octreotide), surgery, prevention and treatment of complications. OBJECTIVE. Describe the symptoms of chylothorax in pediatric surgery patients, as well as its different treatment approach. CLINICAL CASE. A 4-month-old male patient admitted to the pediatric emergency room of the Carlos Andrade Marín Specialties Hospital with respiratory distress, a history of corrected esophageal atresia in the neonatal stage. He came with difficulty breathing, chest radiography showed right pleural effusion. Diagnostic thoracentesis with cloudy and milky-looking fluid outlet, a right chest tube was placed, initial fast, parenteral nutrition for 4 weeks until resolution of the chylothorax was verified, discharged in stable condition. DISCUSSION. Conservative treatment of chylothorax was based on a series of measures; Chylothorax drainage, initial digestive rest, parenteral nutrition, qualitative modification of the enteral diet, the use of octreotide. In the case of the patient, the aforementioned measures were used and the chylothorax approach was successful. CONCLUSIONS. Chylothorax has been a rare pathology in pediatric age, the main cause has been a history of cardiothoracic surgery, its treatment in most cases has been conservative, multidisciplinary management is essential for success in addressing this pathology.