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KMID : 1130320080510111172
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Korean Journal of Pediatrics
2008 Volume.51 No. 11 p.1172 ~ p.1178
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A clinical study of congenital chylothorax and octreotide therapy
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Oh Ung-Geon
Choi Kyong-Eun
Kim Kyung-Ah
Ko Sun-Young
Lee Yeon-Kyung
Shin Son-Moon
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Abstract
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Purpose: Congenital chylothorax is an accumulation of lymphatic fluid within the pleural space. It is a common cause of unidentified hydrops fetalis. We examined the perinatal history, clinical manifestation, diagnosis, treatment, and outcome in 6 newborns diagnosed to have congenital chylothorax with hydrops fetalis. We also studied the effect of octreotide therapy for congenital chylothorax in relation to conservative treatment.
Methods: We retrospectively reviewed the medical records of 6 patients diagnosed to have congenital chylothorax with hydrops fetalis among 2 7 ,9 0 7 newborns who were born at the Cheil General Hospital and Womens Healthcare Center between January 2 0 0 4 and July 2 0 0 7 . The diagnosis of chylothorax is based on the analysis of pleural fluid before and after milk feeding.
Results: Incidence of congenital chylothorax in this study was 0 .0 2 1 %. All 6 cases were noted in over the 9 2% lymphocyte in pleural analysis. Transudate was changed into chyle with increasing triglyceride levels above 2 0 0 mg/dL after milk feeding. Three of 6 infants improved with conservative treatment, including thoracostomy and assisted ventilation. The others had persistent symptoms despite conservative treatment and responded to octreotide therapy. A complication, specifically vomiting was noted in 1 case during octreotide therapy.
Conclusion: In this study, octreotide therapy resulted in a safe and excellent outcome. Therefore, octreotide therapy is considered in severe refractory congenital chylothorax in conservative treatment. Further studies are required to determine appropriate guidelines for octreotide therapy.
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KEYWORD
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Congenital chylothorax, Octreotide, Hydrops fetalis, Clinical study
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