Chylothorax and chylous ascites: Management and pitfalls

摘要: Leakage of lymph from the lymphatic ducts causes chylothorax (CT) or chylous ascitis (CA). This may happen for unknown reasons during fetal life after birth and also be caused by trauma thoracic surgery other conditions. Fetal CT CA lethal particularly in cases with hydrops that sometimes benefit intra-uterine instrumentation. After birth, symptoms are related to amount accumulated fluid. Sometimes, severe cardio-respiratory compromise prompts active therapy. Most patients observation, rest, supportive measures alone. Drainage fluid necessary, but then loss protein, fat, lymphoid cells introduce new risks require careful replacement. Low-fat diets MCT parenteral nutrition decrease production while allowing adequate nutritional input. If leakage does not stop, secretion inhibitors like somatostatin octreotide prescribed, although there is only weak evidence their benefits. Imaging system indicated when leaks persist, this technically demanding children. Shunting one body space another means valved catheters, embolization duct, and/or ligation major lymphatics occasionally refractory all treatments.