Tilmont P, Alessandri J L, Duthoit G, Rossi-Farrer C, Roge-Wolter M
Service de Réanimation Néonatale et Infantile et de Chirurgie Infantile, Centre Hospitalier Félix-Guyon.
Arch Fr Pediatr. 1993 Nov;50(9):783-6.
BACKGROUND. Post-operative chylous effusion is rare in infants. It may result from venous thrombosis, thoracic duct injury or lymphatic vessel obstruction. This paper describes 2 cases of diaphragm hernia with post-operative chylous effusion. CASE REPORTS Case 1: A newborn developed chylous ascites two weeks after repair of a left posterolateral diaphragm hernia. Abdominal paracentesis showed milky fluid containing numerous lymphocytes (98%). Ascites was rapidly reduced by feeding with medium-chain triglyceride-rich (MCT) formula. Case 2: A chylothorax was seen 7 days after surgery to repair a left posterolateral diaphragm hernia. Thoracocentesis showed serous fluid containing numerous lymphocytes (93%). The chylothorax was resolved after two thoracocenteses, parenteral nutrition and feeding with MCT formula. CONCLUSION. These cases are the third report of chylothorax and the second report of chylous ascites after surgical repair of a diaphragm hernia. The exact cause of the chylous effusion is not clear.
背景。术后乳糜性积液在婴儿中罕见。它可能由静脉血栓形成、胸导管损伤或淋巴管阻塞引起。本文描述了2例膈疝术后出现乳糜性积液的病例。病例报告 病例1：一名新生儿在左侧后外侧膈疝修补术后两周出现乳糜性腹水。腹腔穿刺抽出含大量淋巴细胞（98%）的乳状液体。通过喂食富含中链甘油三酯（MCT）的配方奶，腹水迅速减少。病例2：一名新生儿在左侧后外侧膈疝修补术后7天出现乳糜胸。胸腔穿刺抽出含大量淋巴细胞（93%）的浆液性液体。经两次胸腔穿刺、肠外营养及喂食MCT配方奶后，乳糜胸得以消退。结论。这些病例是膈疝手术修复后乳糜胸的第三次报告及乳糜性腹水的第二次报告。乳糜性积液的确切病因尚不清楚。
