Enhancing chylothorax recovery through early enteral nutrition intervention: A case report

Tran Tien Dat, Nguyen Thi Quynh, Nguyen Thi Hang Nga, Bui Thi Khanh Ngoc, Dang Thi Thuy Nga, Nguyen Thi Thuy Hong

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Abstract

Chylothorax is a rare postoperative complication of congenital diaphragmatic hernia repair, associated with significant risks, including malnutrition, immunodeficiency, and complications from long-term total parenteral nutrition (TPN). We present the case of a 1-month-old female infant who developed chylothorax following diaphragmatic hernia repair. The condition was successfully managed using a conservative treatment approach, which included early introduction of enteral nutrition with a high medium-chain triglyceride (MCT) formula combined with parenteral nutrition and comprehensive medical management.

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References

1. Delaney SW, Shi H, Shokrani A, et al. Management of Chyle Leak after Head and Neck Surgery: Review of Current Treatment Strategies. Int J Otolaryngol. 2017;2017:8362874.
2. Beghetti M, La Scala G, Belli D, et al. Etiology and management of pediatric chylothorax. J Pediatr. 2000;136(5):653-658.
3. Soto-Martinez M, Massie J. Chylothorax: diagnosis and management in children. Paediatr Respir Rev. 2009;10(4):199-207.
4. Pan W, Cai SY, Luo HL, et al. The application of nutrition support in conservative treatment of chylous ascites after abdominal surgery. Ther Clin Risk Manag. 2016;12:607-612. doi:10.2147/TCRM.S100266
5. B R Steven, S Carey. Nutritional management in patients with chyle leakage: a systematic review. European Journal of Clinical Nutrition. 2015;69:776-780.
6. Dugue L, Sauvanet A, Farges O, et al. Output of chyle as an indicator of treatment for chylothorax complicating oesophagectomy. Br J Surg. 1998;85(8):1147-1149.
7. Büttiker V, Fanconi S, Burger R. Chylothorax in Children. Chest. 1999;116(3):682-687.
8. Beghetti M, La Scala G, Belli D, et al. Etiology and management of pediatric chylothorax. J Pediatr. 2000;136(5):653-658.
9. Soto-Martinez M, Massie J. Chylothorax: diagnosis and management in children. Paediatr Respir Rev. 2009;10(4):199-207.
10. Valentine VG, Raffin TA. The management of chylothorax. Chest. 1992;102(2):586-591.
11. Ukleja A, Romano MM. Complications of parenteral nutrition. Gastroenterol Clin North Am. 2007;36(1):23-46.
12. Pan S, Cheah L, Bushra R, et al. Impact of early enteral feed composition on the rate of chyle leak post-esophagectomy. Dis Esophagus. 2024;37(6):doae008. doi:10.1093/dote/doae008
13. Winder MM, Vijayarajah S, Reeder RW, et al. Successfully Reducing Fat-modified Diet Duration for Treating Postoperative Chylothorax in Children. Ann Thorac Surg. 2022;114(6):2363-2371. doi:10.1016/j.athorac sur. 2021.10.028