Successful use of octreotide and limited drainage in resistant chylothorax in congenital diaphragmatic hernia

Abstract

In the conservative treatment of postdiaphragmatic hernia chylothorax, use of octreotide (OCT) had variable results. Limited chyle drainage has not been tried. A newborn, after the left Bochdalek diaphragmatic hernia repair, developed chylothorax. Treatment with intercostal chest tube (ICT) drainage, partial parenteral nutrition (PPN), and medium-chain triglyceride (MCT) with formula feeds was ineffective. ICT slipped out on the 13th day in the presence of significant residual chylothorax. Further drainage was not done. Addition of OCT infusion at maximum dose of 6 μg/kg/h cleared the chylothorax. No side effect of OCT was observed. The present case has proved that MCT feeding along with PPN is effective, and limited drainage of chyle is enough with OCT treatment in postdiaphragmatic hernia chylothorax.