Bilateral chylothorax in a newborn.

Abstract

Bilateral chylothorax as a result of superior vena cava (SVC) thrombosis is reported. A 1.6-kg infant drained an average of 240 ml per day from an indwelling chest tube during a 3-wk period after thrombosis of the SVC secondary to an indwelling silastic catheter. This daily fluid loss was 1.7 times the patient's blood volume and was replaced ml for ml with fresh frozen plasma. This extraordinary volume continued despite the patient being NPO and receiving peripheral intravenous nutrition. Since no improvement occurred after a 3-wk period, a thoracotomy was performed. A parietal pleurectomy was performed since on specific site for a chyle leak was identified. The chylothorax cleared immediately following the operation. This patient is unique in both the total volume of chylous drainage obtained (5000 ml) and the surgical technique employed to correct this problem.