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Chylothorax and Other Pleural Effusions in Neonates

  • Richard G. AzizkhanEmail author
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Abstract

Pleural effusion is a general term for the accumulation of fluid in the pleural space. Chylothorax results from the leakage of chyle from the thoracic duct into the pleural cavity and may occur spontaneously, traumatic, iatrogenic, or as malignant infiltration. Whether congenital or acquired, chylothorax frequently resolves with nonoperative measures aimed at optimizing ventilation and maintenance of nutrition. Surgical options such as pleuroperitoneal shunting, thoracic duct ligation, pleurodesis, pleurectomy, and intrapleural fibrin glue can be chosen for severe and persistent cases.

Keywords

Congenital chylothorax Acquired chylothorax Pleural effusion Hydrothorax Hemothorax Empyema 

Notes

Acknowledgment

The author wishes to acknowledge the assistance of Aliza P. Cohen, MA, in the writing of this chapter.

References

  1. Adiotomre PNA, Burns JE, McIntosh N. Hydrops foetalis and chylothorax associated with superior caval vein obstruction and resolution following balloon dilatation. Acta Paediatr. 1994;83:983–5.PubMedCrossRefGoogle Scholar
  2. Aguirre OA, Finley BE, Ridgway III LE, et al. Resolution of unilateral fetal hydrothorax with associated non-immune hydrops after intrauterine thoracentesis. Ultrasound Obstet Gynecol. 1995;5:346–8.PubMedCrossRefGoogle Scholar
  3. Ahmad FK, Sherman SJ, Hagglund KH, et al. Isolated unilateral fetal pleural effusion: the role of sonographic surveillance and in utero therapy. Fetal Diagn Ther. 1996;11:383–9.PubMedCrossRefGoogle Scholar
  4. Al-Hussaini A, Butzner D. Therapeutic applications of octreotide in pediatric patients. Saudi J Gastroenterol. 2012;18:87–94.PubMedPubMedCentralCrossRefGoogle Scholar
  5. Allen EM, van Heeckeren DW, Spector ML, et al. Management of nutritional and infectious complications of postoperative chylothorax in children. J Pediatr Surg. 1991;26:1169–74.PubMedCrossRefGoogle Scholar
  6. Aubard Y, Derouineau I, Aubard V, et al. Primary fetal hydrothorax. A literature review and proposed antenatal clinical strategy. Fetal Diagn Ther. 1998;13:325–33.PubMedCrossRefGoogle Scholar
  7. Azizkhan RG, Canfield J, Alford BA, et al. Pleuroperitoneal shunts in the management of neonatal chylothorax. J Pediatr Surg. 1983;18:842–8.PubMedCrossRefGoogle Scholar
  8. Be C, Wilson NJ, Finucane K, West TM. Use of Monogen for pediatric postoperative chylothorax. Ann Thorac Surg. 2004;77:301–5.CrossRefGoogle Scholar
  9. Beghetti M, LaScala G, Belli D, et al. Etiology and management of pediatric chylothorax. J Pediatr. 2000;136:653–8.PubMedCrossRefGoogle Scholar
  10. Bellini C, Mazzella M, Campisi C, et al. Multimodal imaging in the congenital pulmonary lymphangiectasia-congenital chylothorax-hydrops fetalis continuum. Lymphology. 2004;37:22–30.PubMedGoogle Scholar
  11. Blalock A, Cunningham RS, Robinson CS. Experimental production of chylothorax by occlusion of the superior vena cava. Ann Surg. 1936;104:359–63.PubMedPubMedCentralCrossRefGoogle Scholar
  12. Blott M, Nicolaides KH, Greenough A. Pleuroamniotic shunting for decompression of fetal pleural effusions. Obstet Gynecol. 1988;71:798–800.PubMedGoogle Scholar
  13. Bradley JS, Byington CL, Shah SS, et al. Executive summary: the management of community acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the pediatric infectious disease society and the infectious disease Society of America. Clin Infect Dis. 2011;53:617–30.PubMedPubMedCentralCrossRefGoogle Scholar
  14. Brodman RF. Congenital chylothorax, recommendations for treatment. N Y State J Med. 1975;75:553–7.PubMedGoogle Scholar
  15. Calder A, Owens CM. Imaging of parapneumonic pleural effusions and empyema in children. Pediatr Radiol. 2009;39:527–37.PubMedCrossRefGoogle Scholar
  16. Casado-Flores J, Barja J, Martino R, et al. Complications of central venous catheterization in critically ill children. Pediatr Crit Care Med. 2001;2:57–62.PubMedCrossRefGoogle Scholar
  17. Caverly L, Rausch CM, da Cruz E, Kaufman J. Octreotide treatment of chylothorax in pediatric patients following cardiothoracic surgery. Congenit Heart Dis. 2010;5:573–8.PubMedCrossRefGoogle Scholar
  18. Cevese PG, Vecchioni R, D’Amico DF, et al. Postoperative chylothorax. J Thorac Cardiovasc Surg. 1975;69:966–71.PubMedGoogle Scholar
  19. Chan BBK, Murphy MC, Rodgers BM. Management of chylopericardium. J Pediatr Surg. 1990;25:1185–9.PubMedCrossRefGoogle Scholar
  20. Chan EH, Russell JL, Williams WG, et al. Postoperative chylothorax after cardiothoracic surgery in children. Ann Thorac Surg. 2005;80:1864–71.PubMedCrossRefGoogle Scholar
  21. Chan SY, Lau W, Wong WH, et al. Chylothorax in children after congenital heart surgery. Ann Thorac Surg. 2006;82:1650–6.PubMedCrossRefGoogle Scholar
  22. Chen W, Adams D, Patel M, et al. Generalized lymphatic malformation with chylothorax: long-term management of a highly morbid condition in a pediatric patient. J Pediatr Surg. 2013;48:e9–12.PubMedCrossRefGoogle Scholar
  23. Cheung Y, Leung MP, Yip M. Octreotide for treatment of post-operative chylothorax. J Pediatr. 2001;139:157–9.PubMedCrossRefGoogle Scholar
  24. Claris O, Besnier S, Lapillonne A, et al. Chylothorax following surgical repair of congenital diaphragmatic hernia in five neonates. Prenat Neonat Med. 1996;1:94–6.Google Scholar
  25. Cleveland K, Zook D, Harvey K, Woods RK. Massive chylothorax in small babies. J Pediatr Surg. 2009;44:546–50.PubMedCrossRefGoogle Scholar
  26. Curci MR, Debbins AW. Bilateral chylothorax in a newborn. J Pediatr Surg. 1980;15:663–5.PubMedCrossRefGoogle Scholar
  27. Das A, Shah PS. Octreotide for the treatment of chylothorax in neonates. Cochrane Database Syst Rev. 2010;CD006388.Google Scholar
  28. Densupsoontorn N, Jirapinyo P, Wongarn R, et al. Management of chylothorax and chylopericardium in pediatric patients: experiences at Siriraj hospital, Bangkok. Asia Pac J Clin Nutr. 2005;14:182–7.PubMedGoogle Scholar
  29. Deurloo KL, Devlieger R, Lopriore E, et al. Isolated fetal hydrothorax with hydrops: a systematic review of prenatal treatment options. Prenat Diagn. 2007;27:893–9.PubMedCrossRefGoogle Scholar
  30. Devine PC, Malone FD. Noncardiac thoracic anomalies. Clin Perinatol. 2000;27:865–99.PubMedCrossRefGoogle Scholar
  31. Dhande V, Kattwinkel J, Alford B. Recurrent bilateral pleural effusion secondary to superior vena cava obstruction as a complication of central venous catheterization. Pediatrics. 1983;72:109–13.PubMedGoogle Scholar
  32. Dutheil P, Leraillez J, Guillemette J, et al. Generalized lymphangiomatosis with skin lymphangiomas in a neonate. Pediatr Dermatol. 1998;15:296–8.PubMedCrossRefGoogle Scholar
  33. Easa D, Balaraman V, Ash K, et al. Congenital chylothorax and mediastinal neuroblastoma. J Pediatr Surg. 1991;26:96–8.PubMedCrossRefGoogle Scholar
  34. Engum SA, Rescorla FJ, West KW, et al. The use of pleuroperitoneal shunts in the management of persistent chylothorax in infants. J Pediatr Surg. 1999;34:286–90.PubMedCrossRefGoogle Scholar
  35. Feliciano DV, Mattox KL, Graham JM, et al. Major complications of percutaneous subclavian vein catheters. Am J Surg. 1979;138:869–74.PubMedCrossRefGoogle Scholar
  36. Fisher E, Weiss EB, Michaels K, et al. Spontaneous chylothorax in Noonan’s syndrome. Br J Pediatr. 1982;138:282–4.Google Scholar
  37. Foote KD, Vickers DW. Congenital pleural effusion in Down’s syndrome. Br J Radiol. 1986;59:609–10.PubMedCrossRefGoogle Scholar
  38. Gates RL, Caniano DA, Hayes JR, Arca MJ. Does VATS provide optimal treatment of empyema in children? A systematic review. J Pediatr Surg. 2004;39:381–6.PubMedCrossRefGoogle Scholar
  39. Goens MB, Campbell D, Wiggins JW. Spontaneous chylothorax in Noonan syndrome. AJDC. 1992;146:1453–6.PubMedGoogle Scholar
  40. Goyal A, Smith NP, Jesudason EC, et al. Octreotide for treatment of postoperative chylothorax after repair of congenital diaphragmatic hernia. J Pediatr Surg. 2003;38:E19–20.PubMedCrossRefGoogle Scholar
  41. Haller JA. Thoracic injuries. In: Welch KJ, Randolph JG, Ravich MM, editors. Pediatric surgery. 4th ed. Chicago: Year Book Medical Publishers; 1986. p. 143–54.Google Scholar
  42. Hamada H, Fujita K, Kubo T, et al. Congenital chylothorax in a trisomy 21 newborn. Arch Gynecol Obstet. 1992;252:55–8.PubMedCrossRefGoogle Scholar
  43. Helin RD, Angeles ST, Bhat R. Octreotide therapy for chylothorax in infants and children: a brief review. Pediatr Crit Care Med. 2006;7:576–9.PubMedCrossRefGoogle Scholar
  44. Higgins CB, Mulder DG. Chylothorax after surgery for congenital heart disease. J Thorac Cardiovasc Surg. 1971;61:411–8.PubMedGoogle Scholar
  45. Ibrahim H, Asamoah A, Krouskop RW, et al. Congenital chylothorax in neonatal thyrotoxicosis. J Perinatol. 1999;19:68–71.PubMedCrossRefGoogle Scholar
  46. Islam A, Calkins CM, Goldin AB, et al. The diagnosis and management of empyema in children: a comprehensive review from the APSA outcomes and clinical trials committee. J Pediatr Surg. 2012;47:2101–10.PubMedCrossRefGoogle Scholar
  47. Jorgensen C, Brocks V, Bang J, et al. Treatment of severe fetal chylothorax associated with pronounced hydrops with intrapleural injection of OK-432. Ultrasound Obstet Gynecol. 2003;21:66–9.PubMedCrossRefGoogle Scholar
  48. Joyce LD, Lindsay WG, Nicoloff DM. Chylothorax after median sternotomy for intrapericardial cardiac surgery. J Thorac Cardiovasc Surg. 1976;71:476–80.PubMedGoogle Scholar
  49. Kavvadia V, Greenough A, Davenport M, et al. Chylothorax after repair of congenital diaphragmatic hernia – risk factors and morbidity. J Pediatr Surg. 1998;33:500–2.PubMedCrossRefGoogle Scholar
  50. Klam S, Bigras JL, Hudon L. Predicting outcome in primary fetal hydrothorax. Fetal Diagn Ther. 2005;20:366–70.PubMedCrossRefGoogle Scholar
  51. Kramer SS, Taylor GA, Garfinkel DJ, et al. Lethal chylothoraces due to superior vena caval thrombosis in infants. AJR Am J Roentgenol. 1981;137:559–63.PubMedCrossRefGoogle Scholar
  52. Krenke K, Sadowy E, Podsiadły E, Hryniewicz W, Demkow U, Kulus M. Etiology of parapneumonic effusion and pleural empyema in children. The role of conventional and molecular microbiological tests. Respir Med. 2016;116:28–33.PubMedCrossRefGoogle Scholar
  53. Kumar SP, Belik J. Chylothorax – a complication of chest tube placement in a neonate. Crit Care Med. 1984;12:411–2.PubMedCrossRefGoogle Scholar
  54. Laberge JM, Crombleholme TM, Longaker MT. Fetal diseases and their management. In: Harrison MR, Bolbus MS, Filly RA, editors. The unborn patient. 2nd ed. Philadelphia: WB Saunders Co.; 1991. p. 314–9.Google Scholar
  55. Lam JC, Aters S, Tobias JD. Initial experience with octreotide in the pediatric population. Am J Ther. 2001;8:409–15.PubMedCrossRefGoogle Scholar
  56. Lamberts SW, van der Lely AJ, de Herder WW, et al. Octreotide. N Engl J Med. 1996;334:246–54.PubMedCrossRefGoogle Scholar
  57. Lampson RS. Traumatic chylothorax: a review of the literature and report of a case treated by mediastinal ligation of the thoracic duct. J Thorac Surg. 1948;17:778–91.PubMedGoogle Scholar
  58. Le Coultre C, Oberhansli I, Mossaz A, et al. Postoperative chylothorax in children: differences between vascular and traumatic origin. J Pediatr Surg. 1991;26:519–23.PubMedCrossRefGoogle Scholar
  59. Lee SY, Yang SR, Lee KR. Congenital pulmonary lymphangiectasia with chylothorax. Asian Cardiovasc Thorac Ann. 2002;10:76–7.PubMedCrossRefGoogle Scholar
  60. Lee JH, Kim YB, Lee MK, et al. Catastrophic hemothorax on the contralateral side of the insertion of an implantable subclavian venous access device and the ipsilateral side of the removal of the infected port- a case report. Korean J Anesthesiol. 2010;59:214–9.PubMedPubMedCentralCrossRefGoogle Scholar
  61. Lim KA, Kim SH, Huh J, et al. Somatostatin for postoperative chylothorax after surgery for children with congenital heart disease. J Korean Med Sci. 2005;20:947–51.PubMedPubMedCentralCrossRefGoogle Scholar
  62. Liote H, Hamy I, Piganeau N, et al. Neonatal bilateral chylothoraces secondary to obstruction of the superior vena cava (as complication of inadvertent placement of an umbilical vein catheter). Radiographics. 1990;10:152–6.CrossRefGoogle Scholar
  63. Longaker MT, Laberge JM, Dansereau J, et al. Primary fetal hydrothorax: natural history and management. J Pediatr Surg. 1989;24:573–6.PubMedCrossRefGoogle Scholar
  64. Lopez-Gutierrez JC, Tovar JA. Chylothorax and chylous ascites: management and pitfalls. Semin Pediatr Surg. 2014;23(5):298–302.PubMedCrossRefGoogle Scholar
  65. Maayan-Metzger A, Sack J, Mazkereth R, et al. Somatostatin treatment of congenital chylothorax may induce transient hypothyroidism in newborns. Acta Paediatr. 2005;94:785–9.PubMedCrossRefGoogle Scholar
  66. Mandelbrot L, Dommergues M, Aubry MC, et al. Reversal of fetal distress by emergency in utero decompression of hydrothorax. Am J Obstet Gynecol. 1992;167:1278–83.PubMedCrossRefGoogle Scholar
  67. Matsukuma E, Aoki Y, Sakai M, et al. Treatment with OK-432 for persistent congenital chylothorax in newborn infants resistant to octreotide. J Pediatr Surg. 2009;44:E37–9.PubMedCrossRefGoogle Scholar
  68. Matsuo S, Takahashi G, Konishi A, Sai S. Management of refractory chylothorax after pediatric cardiovascular surgery. Pediatr Cardiol. 2013;34:1094–9.PubMedCrossRefGoogle Scholar
  69. Moerman P, Vandenberghe K, Devlieger H, et al. Congenital pulmonary lymphangiectasis with chylothorax: a heterogeneous lymphatic vessel abnormality. Am J Med Genet. 1993;47:54–8.PubMedCrossRefGoogle Scholar
  70. Mohseni-Bod H, Macrae D, Slavik Z. Somatostatin analog (octreotide) in management of neonatal postoperative chylothorax: is it safe? Pediatr Crit Care Med. 2004;5:356–7.PubMedCrossRefGoogle Scholar
  71. Murphy MC, Newman BM, Rodgers BM. Pleuroperitoneal shunts in the management of persistent chylothorax. Ann Thorac Surg. 1989;48:195–200.PubMedCrossRefGoogle Scholar
  72. Mussat P, Dommergues M, Parat S, et al. Congenital chylothorax with hydrops: postnatal care and outcome following antenatal diagnosis. Acta Pediatr. 1995;84:749–55.CrossRefGoogle Scholar
  73. Naik S, Greenough A, Zhang Y-X, et al. Prediction of morbidity during infancy after repair of congenital diaphragmatic hernia. J Pediatr Surg. 1996;31:1651–4.PubMedCrossRefGoogle Scholar
  74. Nakabayashi H, Sagara H, Usukura N, et al. Effect of somatostatin on the flow rate and triglyceride levels of thoracic duct lymph in normal and vagotomized dogs. Diabetes. 1981;30:440–5.PubMedCrossRefGoogle Scholar
  75. Nath EW, Savla J, Khemani RG, et al. Thoracic duct ligation for persistent chylothorax after pediatric cardiothoracic surgery. Ann Thorac Surg. 2009;88:246–51.PubMedCrossRefGoogle Scholar
  76. Nguyen D, Tchervenkov CI. Successful management of postoperative chylothorax with fibrin glue in a premature neonate. Can J Surg. 1994;37:158–60.PubMedGoogle Scholar
  77. Nguyen DM, Shum-Tim D, Dobell AR, Tchervenkov CI. The management of chylothorax/chylopericardium following pediatric cardiac surgery: a 10-year experience. J Card Surg. 1995;10(4 Pt 1):302–8.PubMedCrossRefGoogle Scholar
  78. Nygaard U, Sundberg K, Nielsen HS. New treatment of early fetal chylothorax. Obstet Gynecol. 2007;109:1099–2.CrossRefGoogle Scholar
  79. Okawa T, Takano Y, Fujimori K, et al. A new fetal therapy for chylothorax: pleurodesis with OK-432. Ultrasound Obstet Gynecol. 2001;18:376–7.PubMedCrossRefGoogle Scholar
  80. Ono S, Iwai N, Chiba F, et al. OK-432 therapy for chylous pleural effusion or ascites associated with lymphatic malformations. J Pediatr Surg. 2010;45:E7–E10.PubMedCrossRefGoogle Scholar
  81. Panthongviriyakul C, Bines JE. Post-operative chylothorax in children: an evidence-based management algorithm. J Paediatr Child Health. 2008;44:716–21.PubMedCrossRefGoogle Scholar
  82. Pessotti CF, Jatene IB, Buononato PE, et al. Use of octreotide in the treatment of chylothorax and chyloperitoneum. Arq Bras Cardiol. 2011;97:e33–6.PubMedCrossRefGoogle Scholar
  83. Picone O, Benachi A, Mandelbrot L, et al. Thoracoamniotic shunting for fetal pleural effusions with hydrops. Am J Obstet Gynecol. 2004;191:2047–50.PubMedCrossRefGoogle Scholar
  84. Puntis JWL, Roberts KD, Handy D. How should chylothorax be managed? Arch Dis Child. 1987;62:593–6.PubMedPubMedCentralCrossRefGoogle Scholar
  85. Rheuban KS, Kron IL, Carpenter MA, et al. Pleuroperitoneal shunt for refractory chylothorax after operation for congenital heart disease. Ann Thorac Surg. 1992;53(1):85–7.PubMedCrossRefGoogle Scholar
  86. Rimensberger P, Muller-Shenker B, Kalangos A, et al. Treatment of a persistent postoperative chylothorax with somatostatin. Ann Thorac Surg. 1998;66:253–4.PubMedCrossRefGoogle Scholar
  87. Roberts A, Clarkson P, Pattison N, et al. Fetal hydrothorax in the second trimester of pregnancy: successful intra-uterine treatment at 24 weeks gestation. Fetal Ther. 1986;1:203–6.PubMedCrossRefGoogle Scholar
  88. Robinson C. The management of chylothorax. Ann Thor Surg. 1985;39:90–5.CrossRefGoogle Scholar
  89. Rocha G. Pleural effusions in the neonate. Curr Opin Pulm Med. 2007;13:305–11.PubMedCrossRefGoogle Scholar
  90. Rodeck CH, Fisk NM, Fraser DI, et al. Long-term in-utero drainage of fetal hydrothorax. New Engl J Med. 1988;319:1135–8.PubMedCrossRefGoogle Scholar
  91. Roehr CC, Jung A, Proquitte H, et al. Somatostatin or octreotide as treatment options for chylothorax in young children: a systematic review. Intensive Care Med. 2006;32:650–7.PubMedCrossRefGoogle Scholar
  92. Rosti L, Bini RM, Chessa M, et al. The effectiveness of octreotide in the treatment of post-operative chylothorax. Eur J Pediatr. 2002;161:149–50.PubMedCrossRefGoogle Scholar
  93. Rosti L, De Battisti F, Butera G, et al. Octreotide in the management of postoperative chylothorax. Pediatr Cardiol. 2005;26:440–3.PubMedCrossRefGoogle Scholar
  94. Rubin JW, Moore HV, Ellison RG. Chylothorax: therapeutic alternatives. Am Surg. 1977;43:292–7.PubMedGoogle Scholar
  95. Ruggieto RP, Caruso G. Chylothorax-a complication of subclavian vein catheterization. J Parenter Enter Nutr. 1985;9:750–3.CrossRefGoogle Scholar
  96. Sabin FR. The origin and development of the lymphatic system. Johns Hopkins Hosp Rep. 1916;17:347–440.Google Scholar
  97. Schackelford RT, Fisher AM. Traumatic chylothorax. South Med J. 1938;11:766–75.CrossRefGoogle Scholar
  98. Seguin JH. Right-sided hydrothorax and central venous catheters in extremely low birthweight infants. Am J Perinatol. 1992;9:154–8.PubMedCrossRefGoogle Scholar
  99. Selle JG, Snyder WH, Schreiber JT. Chylothorax: indications for surgery. Ann Surg. 1973;177:245–9.PubMedPubMedCentralCrossRefGoogle Scholar
  100. Stenzl W, Rigler B, Tscheliessnigg KH, et al. Treatment of postsurgical chylothorax with fibrin glue. Thorac Cardiovasc Surg. 1983;31:35–6.PubMedCrossRefGoogle Scholar
  101. Stevenson DA, Pysher TJ, Ward RM, et al. Familial congenital nonimmune hydrops, chylothorax, and pulmonary lymphangiectasia. Am J Med Genet A. 2006;140:368–72.PubMedPubMedCentralCrossRefGoogle Scholar
  102. Tan TQ, Mason Jr EO, Wald ER, et al. Clinical characteristics of children with complicated pneumonia caused by Streptococcus pneumonia. Pediatrics. 2002;110:1–6.PubMedCrossRefGoogle Scholar
  103. Tanemura M, Nishikawa N, Kojima K. A case of successful fetal therapy for congenital chylothorax by intrapleural injection of OK-432. Ultrasound Obstet Gynecol. 2001;18:371–5.PubMedGoogle Scholar
  104. Tauber MT, Harris AG, Rochiccioli P. Clinical use of the long acting somatostatin analogue octreotide in pediatrics. Eur J Pediatr. 1994;153:304–10.PubMedCrossRefGoogle Scholar
  105. Tetsuka K, Endo S, Kanai Y, Yamamoto S. Extralobar pulmonary sequestration presenting as hemothorax. Interact Cardiovasc Thorac Surg. 2009;9:547–8.PubMedCrossRefGoogle Scholar
  106. Thomas HM, Shaw NJ, Weindling AM. Generalized lymphangiomatosis with chylothorax. Arch Dis Child. 1990;65:334.PubMedPubMedCentralCrossRefGoogle Scholar
  107. Tibballs J, Soto R, Bharucha T, et al. Management of newborn lymphangiectasia and chylothorax after cardiac surgery with octreotide infusion. Ann Thorac Surg. 2004;77:2213–5.PubMedCrossRefGoogle Scholar
  108. Van Aerde J, Campbell AN, Smyth JA, Lloyd D. Spontaneous chylothorax in newborns. Am J Dis Child. 1984;138:961–4.PubMedGoogle Scholar
  109. Vain NE, Swarner OW, Cha CC. Neonatal chylothorax. A report and discussion of nine consecutive cases. J Pediatr Surg. 1980;15:261–5.PubMedCrossRefGoogle Scholar
  110. Verunelli F, Georgini V, Luisi VS, et al. Chylothorax following cardiac surgery in children. J Cardiovasc Surg. 1983;24:227–30.Google Scholar
  111. Webber EC, Rescorla FJ. Hemopneumothorax caused by vascularized bullae and a pulmonary hemangioma in an adolescent boy. J Pediatr Surg. 2012;47:E23–5.PubMedCrossRefGoogle Scholar
  112. Weber AM, Philipson EH. Fetal pleural effusion: a review and meta-analysis for prognostic indicators. Obstet Gynecol. 1992;79:281–6.PubMedGoogle Scholar
  113. Williams MS, Josephson KD. Unusual autosomal recessive lymphatic anomalies in two unrelated Amish families. Am J Med Genet. 1997;73:286–9.PubMedCrossRefGoogle Scholar
  114. Wilson-Storey D, MacKinlay GA. Thoraco-abdominal birth injury-presentation, diagnosis and management in an unusual case. Scot Med J. 1987;32:89–90.PubMedCrossRefGoogle Scholar
  115. Yamamoto M, Insunza A, Carrillo J, et al. Intrathoracic pressure in congenital chylothorax: keystone for the rationale of thoracoamniotic shunting? Fetal Diagn Ther. 2007;22:169–71.PubMedCrossRefGoogle Scholar
  116. Yancy WS, Spock A. Spontaneous neonatal pleural effusion. J Pediatr Surg. 1967;2:313–9.PubMedCrossRefGoogle Scholar
  117. Yeager ND, Hammond S, Mahan J, et al. Unique diagnostic features and successful management of a patient with disseminated lymphangiomatosis and chylothorax. J Pediatr Hematol Oncol. 2008;30:66–9.PubMedCrossRefGoogle Scholar
  118. Yeang CH, Ma GC, Shih JC, et al. Genome-wide gene expression analysis implicates the immune response and lymphangiogenesis in the pathogenesis of fetal chylothorax. PLoS One. 2012;7:e34901.PubMedPubMedCentralCrossRefGoogle Scholar
  119. Yinon Y, Kelly E, Ryan G. Fetal pleural effusions. Best Pract Res Clin Obstet Gynaecol. 2008;22:77–96.PubMedCrossRefGoogle Scholar
  120. Yoss BS, Lipsitz PJ. Chylothorax in two mongoloid infants. Clin Genet. 1977;12:357–60.PubMedCrossRefGoogle Scholar
  121. Zuluaga MT. Chylothorax after surgery for congenital heart disease. Curr Opin Pediatr. 2012;24(3):291–4.PubMedCrossRefGoogle Scholar

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Authors and Affiliations

  1. 1.Children’s Hospital & Medical Center, University of Nebraska College of MedicineOmahaUSA

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