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Virtual Pediatric Hospital: Paediapaedia: Chylothorax Paediapaedia: Neonatal Chest Diseases

Chylothorax

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Clinical Presentation:
Respiratory distress. Fifty percent present in first 24 hours of life, and 70% present within one week of birth.

Etiology/Pathophysiology:
Chylothorax is the accumulation of lymphatic fluid in the pleural space. Abruptly elevated venous pressure during delivery can lead to thoracic duct rupture which leads to intrapleural accumulation of lymph fluid. Initially the fluid is serous, but turns chylous after milk feedings. This is the most frequent cause of a large pleural effusion in newborn. It is rarely bilateral, and is rarely associated with generalized lymphangiomatosis. It is diagnosed and usually managed successfully via thoracenteses.

Pathology:
Not applicable

Imaging Findings:
Usually unilateral and usually on right side (60%). icon gif It is difficult to find the exact site of lymph extravasation with contrast studies.

DDX:

References:
See References Chapter.

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