Case report
Octreotide and low-fat breast milk in postoperative chylothorax

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Abstract

Chylothorax is a rare complication following cavo-pulmonary connection and can lead to significant morbidity in infants and young children. We report here the case of a 3-month-old infant who underwent bilateral cavo-pulmonary connections, and developed severe chylothorax refractory to the usual conservative and surgical treatments. His chylothorax resolved after using a combination of parenteral octreotide (Sandostatin, Novartis Pharmaceuticals, East Hanover, NJ) and low-fat breast milk.

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Comment

Chylothorax can occur after cavo-pulmonary connection secondary to central venous hypertension, venous thrombosis, or direct trauma to the lymphatic vessels or the thoracic duct 1, 3. Chyle is formed from lymphatic fluid enriched with fat secreted by intestinal cells [4], and is transported through the thoracic duct into the venous circulation. Surgical treatment is advocated after either excessive (> 10 mL/kg/d or > 100 mL/yr of age), or prolonged ( > 3 to 4 weeks) drainage 1, 3, 4. Surgical

Acknowledgements

This case report was written in compliance with the regulations of the Human Investigation Committee at Yale University School of Medicine. Data regarding the patient's clinical status were collected by chart review. The patient's confidentiality was maintained during data collection and manuscript preparation.

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