1/66. Always remember chylothorax.chylothorax is a rare cause of pleural effusion in association with cardiovascular surgery. A 68-year-old man had a coronary artery bypass graft; 10 days after surgery, he had progressive shortness of breath and a massive left pleural effusion. After chylothorax was diagnosed, it was successfully treated with a thoracostomy tube and total parenteral nutrition. The patient had an uneventful recovery. Nutrition is the most important issue in the treatment of chylothorax. Once chylothorax is identified, nutritional support is the priority, since it will have an important role in the recovery of the patient. Besides our case, we hereby present a short review of the literature regarding the diagnosis and management of this rare entity.- - - - - - - - - - ranking = 1keywords = nutrition (Clic here for more details about this article) |
2/66. chylothorax after myocardial revascularization with the left internal thoracic artery.A 38-year-old male underwent coronary artery bypass grafting (CABG). A saphenous vein graft was attached to the left marginal branch. The left internal thoracic artery was anastomosed to the left anterior descending artery (LAD). The early recovery was uneventful and the patient was discharged on the 5th postoperative day. After three months, he came back to the hospital complaining of weight loss, weakness, and dyspnea on mild exertion. Chest x-rays showed left pleural effusion. On physical examination, a decreased vesicular murmur was detected. After six days, the diagnosis of chylothorax was made after a milky fluid was detected in the plural cavity and total pulmonary expansion did not occur. On the next day, both anterior and posterior pleural drainage were performed by videothoracoscopy, and prolonged parenteral nutrition (PPN) was instituted for ten days. After seven days the patient was put on a low-fat diet for 8 days. The fluid accumulation ceased, the drains were removed and the patient was discharged with normal pulmonary expansion.- - - - - - - - - - ranking = 0.5keywords = nutrition (Clic here for more details about this article) |
3/66. chylothorax after repair of congenital diaphragmatic hernia--a case report.chylothorax is a rarely recognised post-operative complication following repair of congenital diaphragmatic hernia. We report here a newborn infant with this condition which resolved with percutaneous chest drainage, total parenteral nutrition and enteral feeding of a formula high in medium-chain triglycerides.- - - - - - - - - - ranking = 0.5keywords = nutrition (Clic here for more details about this article) |
4/66. Bilateral chylothorax following neck dissection: a new method of treatment.chylothorax is a serious condition with a high rate of morbidity that may lead to death. Although it is encountered more frequently with certain thoracic procedures, it is considered to be a rare complication of neck dissection. Different forms of management have been postulated; however, no consensus of treatment has been achieved. A case of severe bilateral chylothorax that developed after bilateral neck dissection in a patient with laryngeal carcinoma is presented. somatostatin injection was successful after total parenteral nutrition failed to control the chylothorax. On the basis of this case and the review of the literature discussed here, we advocate the use of somatostatin with other conservative measures in the management of chylothorax.- - - - - - - - - - ranking = 0.5keywords = nutrition (Clic here for more details about this article) |
5/66. somatostatin: a new therapeutic option for the treatment of chylothorax.BACKGROUND: The standard treatment of chylothorax in pediatric intensive care today includes conservative therapy with fat-free nutrition, total parenteral nutrition and, if this is not successful, operative treatment (pleurodesis, ligation of the duct, pleuroperitoneal shunt). patients: We describe four patients who were not in a suitable condition for operative treatment and who were treated with continuous infusion of somatostatin. RESULTS: In three patients, chylothorax ceased with the continuous somatostatin infusion without side effects. One patient was treated without success. CONCLUSIONS: somatostatin is a therapeutic option for treatment of chylothorax and could reduce surgical intervention and hospitalization time, as well as allow earlier enteral feeding.- - - - - - - - - - ranking = 1keywords = nutrition (Clic here for more details about this article) |
6/66. chylothorax: a complication after internal thoracic artery harvesting.chylothorax is a rare but serious complication of cardiac surgery. A 64-year-old man with three-vessel disease underwent coronary artery bypass grafting. Ten days later he developed left pleural effusion. An intercostal drain was inserted and 1600 ml of pale pink, milky fluid were obtained. The results of biochemical analysis were consistent with chyle. The diagnosis of a left chylothorax was made. Conservative treatment consisting of total parenteral nutrition and pleural drainage was successfully employed. In the literature we found 17 cases in which the development of chylothorax after a coronary revascularization procedure is described.- - - - - - - - - - ranking = 0.5keywords = nutrition (Clic here for more details about this article) |
7/66. octreotide to treat postoperative chylothorax after cardiac operations in children.chylothorax after pediatric cardiac operations is associated with significant morbidity and increased hospitalization. An octreotide (a synthetic somatostatin analogue) infusion (1 to 4 microg/kg per hour) with medium-chain triglyceride diet or parenteral nutrition was used in 4 pediatric cardiac surgical patients after chylothorax was diagnosed. Resolution followed within 5 days in all without recurrence, while on a normal diet.- - - - - - - - - - ranking = 0.5keywords = nutrition (Clic here for more details about this article) |
8/66. Bilateral chylothorax after left radical neck dissection.Bilateral chylothorax, as a complication of neck dissection, is very rare as evidenced by the 11 cases reported in the literature up to date. We present an additional case of bilateral chylothorax following a left radical neck dissection and concomitant chylous neck fistula. This case was successfully treated by chest drainage and total parenteral nutrition. early diagnosis of chylothorax is urged due to the consequences on metabolism and respiratory conditions. Management by aspiration drainage is usually sufficient to control pleural effusions.- - - - - - - - - - ranking = 0.5keywords = nutrition (Clic here for more details about this article) |
9/66. Treatment of persistent chylothorax after Norwood procedure with somatostatin.A newborn who had undergone Norwood procedure for hypoplastic left heart syndrome developed a voluminous chylothorax that persisted despite weeks of prolonged complete bowel rest, total parenteral nutrition, and effective chest tube drainage. Chest tube output diminished immediately following initiation of intravenous somatostatin, allowing restoration of full enteral feeds and removal of chest tubes within 6 days.- - - - - - - - - - ranking = 0.5keywords = nutrition (Clic here for more details about this article) |
10/66. Non-traumatic chylous effusion in the thorax and abdomen.A female of 31 with chyloascites and bilateral chylothorax is presented. The thoracic duct was obstructed below the diaphragm. The lymph vessels in the left iliac and para-aortic areas were enlarged and there were lymphocysts. When the lymph loss was greatest the patient was in a state of grave malnutrition with marked hypoalbuminaemia and an absolute and relative lymphocytopenia in the blood. "Malignant" cells were demonstrated in the chylous fluid, but no malignancy could be found at laparotomy. It is possible that the cells were confused with immature lymphocytes. The lymphatic cysts were excised and the lymph vessels ligated. Decortication of the right lung was performed. The patient recovered. The follow up time has been over four years.- - - - - - - - - - ranking = 0.5keywords = nutrition (Clic here for more details about this article) |
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