Chest
Clinical InvestigationsThe PleuraChylothorax in Children: Guidelines for Diagnosis and Management
Section snippets
Materials and Methods
We retrospectively analyzed all patients with the diagnosis of chylothorax in our hospital database from the years 1985 to 1996. There were a total of 51 patients having this diagnosis, but we had to exclude 10 patients because of insufficient documentation. An additional two patients were excluded because an analysis of the available data dismissed the diagnosis of chylothorax.
The diagnosis of chylothorax was made according to the proposal of Staats et al4 and Straaten et al7: triglyceride
Results
There were 29 boys and 10 girls with the diagnosis of chylothorax. Their ages ranged from 5 days to 10.5 years old (median, 2.1 years old). The 10 patients in the control group were from 6 days to 7 years old (median, 1.3 years old). All received regular formula.
Thirty-three patients (85%) developed chylothorax after cardiac surgery. From the remaining six patients, two developed chylothorax after pneumonia. One of these patients had Down's syndrome; the second patient was a newborn baby with
Discussion
Chyle is lymphatic fluid enriched with fat secreted by intestinal cells. It is collected and then transported via the thoracic duct into the circulation. Measuring fat content and demonstrating the predominance of lymphocytes in pleural effusion serves to prove chyle. We used the definition of Staats et al4 to define chyle in our patients.
In our 39 patients, the diagnosis of chylothorax was confirmed by pleural effusion with a triglyceride level > 1.1 mmol/L and a cell count >1,000 cells/μL
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