Chylothorax of the newborn

I believe many people know that the body of a newborn is very fragile, mainly because the baby’s immune system and various functions are not fully developed in the early stages, and problems are prone to occur during the development stage. Sometimes newborns are found to have a condition called chylothorax. This is a relatively rare disease in newborns. It has a great impact on their physical health. So when you discover that you have chylothorax, what methods should be used to treat it?

Neonatal chylothorax is a relatively rare disease in the neonatal period, but it is one of the most common causes of pleural effusion in neonates. Pisek first described the disease in 1917. The disease is caused by rupture or obstruction of the thoracic duct or large lymphatic vessels in the chest cavity, leading to abnormal accumulation of lymph fluid, namely chyle, in the chest cavity, causing serious respiratory, nutritional and immune disorders. Common causes of congenital chylothorax are thoracic duct atresia, birth trauma, etc. Once chylothorax occurs, it will cause a series of important pathophysiological changes. The retention of a large amount of chyle in the chest cavity not only causes serious disorders in respiratory and circulatory functions, but also causes serious disorders in metabolism, nutrition and immune system functions. The chyle fluid accumulated in the chest cavity compresses the lungs, reducing vital capacity and causing mediastinal sway. The child experiences shortness of breath or even obvious symptoms of respiratory distress. The clinical symptoms caused by chylothorax generally gradually worsen.

Conservative treatment is the preferred treatment option and includes

① Fasting;

② Or take products containing medium-chain triglycerides;

③Intravenous nutrition;

④ Pleural drainage: Install a closed chest drainage tube

⑤Use tissue adhesives, etc. During conservative treatment, effective closed chest drainage and complete lung expansion must be ensured, the pleural cavity should be reduced as much as possible, and adhesions should be generated between the parietal and visceral pleura, so as to close the fistula of the thoracic duct or its branches and control chylothorax. In conservative treatment, the key issue is to maintain the child's nutrition and keep the water and electrolyte balance.

Definition: Chylothorax is caused by rupture or obstruction of the thoracic duct due to various reasons, resulting in the overflow of chyle into the chest cavity. The thoracic duct is the largest lymphatic vessel in the body, with a total length of about 30 to 40 cm. It is divided into two parts: one is the manifestation of the primary disease; the other is the symptoms of chylothorax itself. Traumatic thoracic duct rupture causes rapid overflow of chyle, which can produce compression symptoms. Chylothorax is caused by thoracic duct rupture or obstruction due to various reasons, causing chyle to overflow into the chest cavity. The thoracic duct is the largest lymphatic vessel in the body, with a total length of about 30 to 40 cm. It originates from the cisterna chyli in front of the first lumbar vertebra in the abdominal cavity, passes through the aortic hiatus, crosses the diaphragm and enters the mediastinum. Then go up along the right front of the vertebral body and the back of the esophagus, and cross the vertebral body obliquely to the upper left at the fifth thoracic vertebra. It ascends to the left side of the vertebral body and esophagus to the neck, passes behind the carotid sheath, crosses the subclavian artery and returns to the left venous angle.