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British Journal of Anaesthesia, 1991, Vol. 66, No. 3 387-390
© 1991 The Board of Management and Trustees of the British Journal of Anaesthesia

case-report

BILATERAL CHYLOTHORAX

P. COOPER, B.SC.(HONS), F.C.ANAES. and M. L. PAES, F.C.ANAES.

Department of Cardiothoracic Anaesthesia, Regional Cardiothoracic Centre, Freeman Hospital Freeman Road, Newcastle upon Tyne NE7 7DN

Correspondence to M.L.P.

A 2.5-kg female developed bilateral chylothoraces 10 days after surgery for coarctation of the aorta. Initial conservative management consisted of intermittent positive pressure ventilation, drainage of chylous fluid and enteral feeding, but there was no diminution in loss of chyle. Ligation of the thoracic duct and pleurectomy were performed subsequently to reduce the large daily losses of chyle, amounting to nearly three times the child's circulating blood volume. Brawny oedema of the right upper quadrant of the body developed rapidly after the duct ligation and right pleurectomy. A further period of conservative treatment was required before the latter complication resolved. The literature relating to this iatrogenic complication and to fluid and nutritional losses in paediatric chylothorax is reviewed and discussed.


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