Çocukluk Çağında Şilotoraks; Üç Olgu Sunumu, Güncel Tanı ve Tedavi Yaklaşımları

Abstract

Chylothorax is a rare cause of pleural effusion in childhood. Even though the etiology of the illness varies according to age, the major causes have been reported to be congenital causes, surgical procedures, trauma, tumoral factors, idiopathic and some infectious diseases. The three pediatric cases diagnosed as chylothorax with the help of clinical and radiological findings and pleural fluid analysis presented here include a 2.5-month-old female patient (idiopathic non-immune hydrops fetalis-associated congenital chylothorax), a 3.5-month-old male patient (idiopathic chylothorax) and an 11-month old male patient (idiopathic chylothorax). All three patients recovered with medical treatment (case 1; total parenteral nutrition and formula containing medium-chain fatty acids; case 2; total parenteral nutrition and formula containing medium chain fatty acids and somatostatin; case 3; formula containing medium chain fatty acids) supplemented by chest tube drainage. No recurrence was observed in any of the cases during the follow-up period. The diagnosis of chylothorax is made through clinical findings, radiology and the analysis of pleural fluid. In cases that fail to respond to treatment with diet and total parenteral nutrition, a successful outcome can be possible with the addition of somatostatin or octreotide treatment. Surgical treatment can be used in cases resistant to medical treatment.