A case of congenital chylothorax treated with octreotide

Abstract

Congenital chylothorax, an abnormal accumulation of chylous fluid in the pleural space, is a common cause of pleural effusion in the neonatal period. The traditional management of chylothorax is conservative. Conservative therapy includes chest drainage, cessation of breast feeding, and using of medium chain triglycerides or total parenteral nutrition. Recently, octreotide, a long-acting somatostatin analog reduced lymphatic fluid production, has been used as a new treatment strategy in the therapy of chylothorax. In a full term newborn with right pleural effusion diagnosed by prenatal ultrasound, congenital chylothorax is confirmed after birth. This patient was initially treated with chest tube insertion. Afterward a mediumchain- triglyceride-enriched formula was initiated. Subcutaneous octreotide was administered to the patient because of non-responded to conservative therapy. The chylothorax resolved promptly with no observed side effects. Octreotide appears to have a good safety drug in newborn infants and remains a promising alternative therapy to surgery for intractable cases with chylothoraces. © The Journal of Current Pediatrics, published by Galenos Publishing.