Abstract
IntroductionChylothorax is a rare complication of surgical neck dissection. This is the first reported pediatric case of bilateral chylothorax following cervical surgery and the first to occur after tracheoplasty. Chylothorax can lead to significant complications, including hypoxemia and shock, and requires timely treatment. This case report discusses the clinical presentation, diagnosis, and treatment of our patient and reviews possible pathophysiologic mechanisms to explain the development of postoperative bilateral chylous effusions.Case presentationAn 18-month-old white baby girl with a complex past medical history including choanal atresia, atrioventricular septal defect, failure to thrive, developmental delay, and tracheostomy dependence developed significant hypoxemia and shock following a routine tracehostomy revision. She was subsequently found to have developed massive bilateral chylothorax, requiring escalation of mechanical ventilation, thoracostomy tube drainage, vasoactive support, and eventual surgical ligation of her thoracic duct.ConclusionsMassive bilateral chylothorax is a rare but potentially life-threatening complication following tracheoplasty. Clinicians caring for this patient population postoperatively should be aware of this potential complication and its management.
Highlights
Chylothorax is a rare complication of surgical neck dissection
Massive bilateral chylothorax is a rare but potentially life-threatening complication following tracheoplasty. Clinicians caring for this patient population postoperatively should be aware of this potential complication and its management
Chyle is lymphatic fluid absorbed from the intestinal tract; it is rich in triglycerides, lymphocytes, immunoglobulins, and other small-molecular-weight proteins
Summary
Chylothorax is a rare complication of neck surgery. This is the first reported pediatric case of bilateral chylothorax following cervical surgery and the first to occur after tracheoplasty. Clinicians caring for patients after neck dissection should be aware of this rare but significant complication and the various strategies for effective treatment. Consent Written informed consent was obtained from the patient’s mother for publication of this case report and accompanying images. Authors’ contributions ALT reviewed the clinical course and participated in drafting and revising the manuscript. JY participated in drafting and revising the manuscript. KWK supervised the overall effort and participated in drafting and revising the manuscript. All authors read and approved the final manuscript
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