RSS-Feed abonnieren
DOI: 10.1055/s-0031-1293363
Kongenitaler Chylothorax – Eine systematische Untersuchung eigener Fälle und Review der Literatur
Ziel: Aufgrund der Seltenheit des kongenitalen Chylothorax stützen sich aktuelle Empfehlungen lediglich auf einzelne Fallbeschreibungen. Zielsetzung der Studie war es die wichtigsten medizinischen Parameter bezüglich des Krankheitsverlaufs zu beschreiben, mögliche Beeinträchtigungen der Lungenfunktion zu dokumentieren und Therapieempfehlungen zu entwickeln.
Methodik: Die Daten aller Kinder, die in den letzten 15 Jahren an der Uniklinik in Graz mit kongenitalem Chylothorax behandelt wurden, wurden retrospektiv ausgewertet. Zusätzlich wurden eine telefonische Befragung der Eltern und eine Lungenfunktionsdiagnostik durchgeführt. Die Literaturrecherche wurde in englisch- und deutschsprachigen, wissenschaftlichen Datenbanken durchgeführt. Einschlusskriterien waren der Nachweis mittels biochemischer Analyse des Ergusses (Lymphozyten-Rate>80% bzw. Nachweis von Chylomikronen) und ein spontanes Auftreten innerhalb der ersten zwei Lebensmonate.
Ergebnis: In Graz wurden 6 Kinder mit kongenitalem Chylothorax behandelt. Alle Kinder überlebten. Ein Follow-up war bei allen sechs Kindern möglich und erfolgte im Durchschnitt im Alter von 7 Jahren. In einem Fall wurde die Diagnose eines Noonan-Syndroms, bei einem anderen die eines Autismus gestellt. In der Lungenfunktionsuntersuchung zeigte sich bei 3 Kindern ein grenzwertig pathologischer Befund.Für den Review wurden 361 Fälle berücksichtigt. Eine intrauterine Diagnosestellung erfolgte in 61%, eine intrauterine Intervention in 68% aller Fälle. 75% zeigten bereits bei der Geburt Symptome. Eine MCT-Diät wurde bei 29% und seit 2003 Octreotid in 19% aller Fälle eingesetzt. Eine operative Sanierung wurde bei 14% durchgeführt. Die Mortalitätsrate betrug 26%.
Schlussfolgerung: Klinische Studien zu Therapieempfehlungen fehlen. Der Verlauf und die Prognose sind vorwiegend von bestehenden Begleiterkrankungen abhängig. Meist gelingt ein Ausheilen mittels konservativer Therapie. Bei fehlendem Ansprechen sollte vor operativer Intervention eine Therapie mittels Octreotid erfolgen.
|
in Graz dokumentierte Fälle |
Review der Literatur |
|
|
Männlich: weiblich |
100%: 0% |
54%: 46% |
|
Durchschnittliches GA (in Wochen) |
36 Wochen (33.–40. SSW) |
35 Wochen (26.–41. SSW) |
|
Anzahl der Frühgeborenen |
67% |
64% |
|
Durchschnittliches Geburtsgewicht (in Gramm) |
2.600g (1.740–3.788g) |
2.920g (467–4.430g) |
|
Anzahl der Fälle mit pränataler Diagnosestellung |
83% |
61% |
|
Durchschnittliches GA bei intrauteriner Diagnosestellung((BR))(in Wochen) |
33. SSW (31.–39. SSW) |
31. SSW (16.–39. SSW) |
|
Anzahl der Fälle mit pränataler Intervention |
60% |
68% |
|
Durchschnittliches GA bei intrauteriner Intervention (in Wochen) |
32. SSW (32.–33. SSW) |
31. SSW (20.–36. SSW) |
|
Auftreten des Chylothorax bilateral: rechts unilateral: ((BR))links unilateral |
100%: 0%: 0% |
70%: 20%: 10% |
|
Anzahl der Fälle mit Hydrops fetalis |
33% |
41% |
|
Anzahl der Fälle mit assoziierten Anomalien |
50% |
25% |
|
Anzahl der Fälle mit Chromosomenanomalien bzw. genetischen Syndromen |
17% |
14% |
|
Auftreten der respiratorischen Symptome bei der Geburt |
100% |
75% |
|
Durchschnittliche Dauer der maschinellen Beatmung (in Tagen) |
34 Tage (9–53 Tage) |
16 Tage (1–120 Tage) |
|
Durchschnittliche Dauer der Pleuradrainage (in Tagen) |
32 Tage (15–62 Tage) |
19 Tage (1–90 Tage) |
|
Durchschnittliche Dauer der parenteralen Ernährung (in Tagen) |
34 Tage (10–67 Tage) |
11 Tage (1–81 Tage) |
|
Anzahl der Fälle, die mit einer MCT-Diät behandelt wurden |
100% |
29% |
|
Anzahl der Fälle, die mit Octreotid behandelt wurden |
50% |
19% |
|
Anzahl der Fälle mit operativer Sanierung |
17% |
14% |
|
Durchschnittlicher Zeitpunkt der operativen Sanierung (in Tagen) |
54 Tage |
47 Tage (14–150 Tage) |
|
Gesamtmortalitätsrate |
0% |
26% |
|
Durchschnittliche Dauer des Krankenhausaufenthaltes (in Tagen) |
67 Tage (37–104 Tage) |
37 Tage (10–113 Tage) |
|
Fall |
Alter bei Durch-führung des Follow-up (in Jahren) |
Weitere stationäre Krankenhausaufent-halte aufgrund internistischer Krankheitsbilder |
Rezi-divierende respirator-ische Infektionen |
Allergien und regel-mäßige Medikation |
Geistige und körperliche Entwicklung |
Spezielle Fördermaß-nahmen |
|
1 |
12 |
Nein |
Nein |
Keine |
Leichter statomotorischer Entwicklungs-rückstand bis ins Alter von 3 Jahren |
Keine |
|
2 |
7½ |
2x (GI-Infekt, allergische Reaktion) |
Ja (inkl. Asthma) |
Frühblüher und Tierhaare; Flixotide® |
Unauffällig |
Keine |
|
3 |
7 |
Nein |
Nein |
Keine |
Minderwuchs (Noonan-Syndrom) |
Keine |
|
4 |
7 |
2x (Aspiration, Purpura Schönlein-Henoch) |
Nein |
Keine |
Sprachverzögerung (Taubstumme Eltern und Geschwister), leichte motorische Retardierung |
Hör-Früh-((BR))förderung |
|
5 |
4½ |
1x (fieberhafter Infekt) |
Ja |
Keine |
Leichter statomotorischer Entwicklungs-rückstand bis ins Alter von 22 Monaten |
Ev. Logopädin |
|
6 |
3½ |
1x (Pneumonie) |
Ja |
Keine |
Autismus, Motorische Retardierung und muskuläre Hypotonie |
Ergotherapie, Physio-therapie, Logopädin |
|
Fall |
Befund |
|
1 |
Grenzbefund zur Restriktion; gering erhöhte Resistance; Grenzbefund zur Überblähung |
|
2 |
Eher kleine Lunge; Kurvilinearität in der Fluss-Volumen-Kurve |
|
3 |
Normalbefund |
|
4 |
Normalbefund |
|
5 |
geringgradige Obstruktion; Besserung nach Sultanol-Inhalation |
Literatur: [1] Pisek G. Report of a case of chylothorax. Arch. Pediat. 1917;34:929–932.
[2] Stewart C, Linner H. Chylothorax in the newborn infant: report of a case. Am J Dis Child. 1926;31(5):654–656.
[3] Defoort P, Thiery M. Antenatal diagnosis of congenital chylothorax by gray scale sonography. J. Clin. Ultrasound. 1978;6(1):47–48.
[4] Ergaz Z, Bar-Oz B, Yatsiv I, Arad I. Congenital chylothorax: clinical course and prognostic significance. Pediatr. Pulmonol. 2009 Aug;44(8):806–811.
[5] Maayan-Metzger A, Sack J, Mazkereth R, Vardi A, Kuint J. Somatostatin treatment of congenital chylothorax may induce transient hypothyroidism in newborns. Acta Paediatr. 2005 Juni;94(6):785–789.
[6] Brodman RF. Congenital chylothorax. Recommendations for treatment. N Y State J Med. 1975März;75(4):553–557.
[7] Yancy WS, Spock A. Spontaneous neonatal pleural effusion. J. Pediatr. Surg. 1967 Aug;2(4):313–319.
[8] Rocha G, Fernandes P, Rocha P, Quintas C, Martins T, Proença E. Pleural effusions in the neonate. Acta Paediatr. 2006 Juli;95(7):791–798.
[9] Caserío S, Gallego C, Martin P, Moral M, Pallás C, Galindo A. Congenital chylothorax: from foetal life to adolescence. Acta Paediatr [Internet]. 2010 Mai 28 [zitiert 2010 Sep 24];Available from:http://www.ncbi.nlm.nih.gov/pubmed/20528795
[10] Tsukimori K, Nakanami N, Fukushima K, Yoshimura T, Hikino S, Nakano H. Pleural fluid/serum immunoglobulin ratio is a diagnostic marker for congenital chylothorax in utero. J Perinat Med. 2006;34(4):313–317.
[11] Kallanagowdar C, Craver RD. Neonatal pleural effusion. Spontaneous chylothorax in a newborn with trisomy 21. Arch. Pathol. Lab. Med. 2006 Feb;130(2):e22–23.
[12] Chen CP. Fetal therapy and cytogenetic testing: prenatal detection of chromosome aberration during thoracocentesis for congenital chylothorax by karyotyping from pleural effusion fluid and review of the literature. Genet. Couns. 2005;16(3):301–305.
[13] Miera O, Mildenberger E, van Baalen A, Fuhr N. [Neonatal chylothorax with trisomy 21]. Z Geburtshilfe Neonatol. 2004 Feb;208(1):29–31.
[14] Turan O, Canter B, Ergenekon E, Koç E, Atalay Y. Chylothorax and respiratory distress in a newborn with trisomy 21. Eur. J. Pediatr. 2001 Dez;160(12):744–745.
[15] Al-Tawil K, Ahmed G, Al-Hathal M, Al-Jarallah Y, Campbell N. Congenital chylothorax. Am J Perinatol. 2000;17(3):121–126.
[16] Puddy V, Lam BC, Tang M, Wong KY, Lam YH, Wong K, u.a. Variable levels of mosaicism for trisomy 21 in a non-immune hydropic infant with chylothorax. Prenat. Diagn. 1999 Aug;19(8):764–766.
[17] Yamamoto T, Koeda T, Tamura A, Sawada H, Nagata I, Nagata N, u.a. Congenital chylothorax in a patient with 21 trisomy syndrome. Acta Paediatr Jpn. 1996 Dez;38(6):689–691.
[18] Mussat P, Dommergues M, Parat S, Mandelbrot L, de Gamarra E, Dumez Y, u.a. Congenital chylothorax with hydrops: postnatal care and outcome following antenatal diagnosis. Acta Paediatr. 1995 Juli;84(7):749–755.
[19] Hamada H, Fujita K, Kubo T, Iwasaki H. Congenital chylothorax in a trisomy 21 newborn. Arch. Gynecol. Obstet. 1992;252(1):55–58.
[20] Van Aerde J, Campbell AN, Smyth JA, Lloyd D, Bryan MH. Spontaneous chylothorax in newborns. Am. J. Dis. Child. 1984 Okt;138(10):961–964.
[21] Yoss BS, Lipsitz PJ. Chylothorax in two mongoloid infants. Clin. Genet. 1977 Dez;12(6):357–360.
[22] Chen CH, Chen TH, Kuo SJ, Chen CP, Lee DJ, Ke YY, u.a. Genetic evaluation and management of fetal chylothorax: review and insights from a case of Noonan syndrome. Lymphology. 2009 Sep;42(3):134–138.
[23] Schlüter G, Steckel M, Schiffmann H, Harms K, Viereck V, Emons G, u.a. Prenatal DNA diagnosis of Noonan syndrome in a fetus with massive hygroma colli, pleural effusion and ascites. Prenat. Diagn. 2005 Juli;25(7):574–576.
[24] Carvalho DR, Alves VVB, Minaré-Júnior A, Peres LC, Pina-Neto JM, Ramos ES. Noonan syndrome associated with unilateral iris coloboma and congenital chylothorax in an infant. Clin. Dysmorphol. 2003 Apr;12(2):143–144.
[25] Prasad R, Singh K, Singh R. Bilateral congenital chylothorax with Noonan syndrome. Indian Pediatr. 2002 Okt;39(10):975–976.
[26] Chan DK, Ho NK. Noonan syndrome with spontaneous chylothorax at birth. Aust Paediatr J. 1989 Okt;25(5):296–298.
[27] Stevenson DA, Pysher TJ, Ward RM, Carey JC. Familial congenital non-immune hydrops, chylothorax, and pulmonary lymphangiectasia. Am. J. Med. Genet. A. 2006 Feb 15;140(4):368–372.
[28] Chang Y, Lien R, Wang C, Chang S, Soong Y. Congenital chylothorax in three siblings. Am. J. Obstet. Gynecol. 2005 Juni;192(6):2065–2066.
[29] Battin MR, Yan J, Aftimos S, Roberts A. Congenital chylothorax in siblings. BJOG. 2000 Dez;107(12):1516–1518.
[30] Fox GF, Challis D, O'Brien KK, Kelly EN, Ryan G. Congenital chylothorax in siblings. Acta Paediatr. 1998 Sep;87(9):1010–1012.
[31] Moerman P, Vandenberghe K, Devlieger H, Van Hole C, Fryns JP, Lauweryns JM. Congenital pulmonary lymphangiectasis with chylothorax: a heterogeneous lymphatic vessel abnormality. Am. J. Med. Genet. 1993 Aug 1;47(1):54–58.
[32] King PA, Ghosh A, Tang MH, Lam SK. Recurrent congenital chylothorax. Prenat. Diagn. 1991 Okt;11(10):809–811.
[33] Wilson RD, Pawel B, Bebbington M, Johnson MP, Lim F, Stamilio D, u.a. Congenital pulmonary lymphangiectasis sequence: a rare, heterogeneous, and lethal etiology for prenatal pleural effusion. Prenat. Diagn. 2006 Nov;26(11):1058–1061.
[34] Dempsey EM, Sant'Anna GM, Williams RL, Brouillette RT. Congenital pulmonary lymphangiectasia presenting as nonimmune fetal hydrops and severe respiratory distress at birth: not uniformly fatal. Pediatr. Pulmonol. 2005 Sep;40(3):270–274.
[35] Bellini C, Mazzella M, Campisi C, Taddei G, Mosca F, Tomà P, u.a. Multimodal imaging in the congenital pulmonary lymphangiectasia-congenital chylothorax-hydrops fetalis continuum. Lymphology. 2004März;37(1):22–30.
[36] Brissaud O, Desfrere L, Mohsen R, Fayon M, Demarquez JL. Congenital idiopathic chylothorax in neonates: chemical pleurodesis with povidone-iodine (Betadine). Arch. Dis. Child. Fetal Neonatal Ed. 2003 Nov;88(6):F531–533.
[37] Bellini C, Mazzella M, Arioni C, Campisi C, Taddei G, Tomà P, u.a. Hennekam syndrome presenting as nonimmune hydrops fetalis, congenital chylothorax, and congenital pulmonary lymphangiectasia. Am. J. Med. Genet. A. 2003 Juli 1;120A(1):92–96.
[38] Fryns JP, Moerman P. 46,XY/46,XX mosaicism and congenital pulmonary lymphangiectasis with chylothorax. Am. J. Med. Genet. 1993 Nov 1;47(6):934–935.
[39] Frey G, Tiller R, Rockel A, Melzer H. [Hydro- and chylothorax during the neonatal period]. Kinderarztl Prax. 1977 Apr;45(4):151–155.
[40] de Bruijn D, van Oort A, Kapusta L. Ebstein's anomaly with severe hypoplastic and stenotic pulmonary venous connections: an unusual cause of congenital chylothorax. Ultrasound Obstet Gynecol. 2007 Nov;30(6):910–912.
[41] Römer S, Opgen-Rhein B, Chaoui R, Scheer I, Czernik C, Obladen M. Bilateral agenesis of the superior vena cava associated with congenital hydrothorax. Ultrasound Obstet Gynecol. 2006 Nov;28(6):842–844.
[42] Geneviève D, Walter E, Gorry P, Jacquemont ML, Dupic L, Layet V, u.a. Gorlin syndrome presenting as prenatal chylothorax in a girl. Prenat. Diagn. 2005 Nov;25(11):997–999.
[43] Wasmuth-Pietzuch A, Hansmann M, Bartmann P, Heep A. Congenital chylothorax: lymphopenia and high risk of neonatal infections. Acta Paediatr. 2004 Feb;93(2):220–224.
[44] Young S, Dalgleish S, Eccleston A, Akierman A, McMillan D. Severe congenital chylothorax treated with octreotide. J Perinatol. 2004März;24(3):200–202.
[45] Fernández Alvarez JR, Kalache KD, GraÅ–el EL. Management of spontaneous congenital chylothorax: oral medium-chain triglycerides versus total parenteral nutrition. Am J Perinatol. 1999;16(8):415–420.
[46] Ozkan H, Ay N, Ozaksoy D, Ercal D, Erata Y, Durak H, u.a. Congenital chylothorax. Turk. J. Pediatr. 1996März;38(1):113–117.
[47] Dutheil P, Leraillez J, Guillemette J, Wallach D. Generalized lymphangiomatosis with chylothorax and skin lymphangiomas in a neonate. Pediatr Dermatol. 1998 Aug;15(4):296–298.
[48] Harvey JG, Houlsby W, Sherman K, Gough MH. Congenital chylothorax: report of unique case associated with 'H' -type tracheo-oesophageal fistula. Br J Surg. 1979 Juli;66(7):485–487.
[49] VAN PERNIS PA. Variations of the thoracic duct. Surgery. 1949 Nov;26(5):806–809.
[50] Beghetti M, La Scala G, Belli D, Bugmann P, Kalangos A, Le Coultre C. Etiology and management of pediatric chylothorax. J. Pediatr. 2000 Mai;136(5):653–658.
[51] Ma G, Liu C, Chang S, Yeh K, Ke Y, Chen T, u.a. A recurrent ITGA9 missense mutation in human fetuses with severe chylothorax: possible correlation with poor response to fetal therapy. Prenat. Diagn. 2008 Nov;28(11):1057–1063.
[52] Nygaard U, Sundberg K, Nielsen HS, Hertel S, Jørgensen C. New treatment of early fetal chylothorax. Obstet Gynecol. 2007 Mai;109(5):1088–1092.
[53] Tsukihara A, Tanemura M, Suzuki Y, Sato T, Tanaka T, Suzumori K. Reduction of pleural effusion by OK-432 in a fetus complicated with congenital hydrothorax. Fetal. Diagn. Ther. 2004 Aug;19(4):327–331.
[54] Jorgensen C, Brocks V, Bang J, Jorgensen FS, Rønsbro L. Treatment of severe fetal chylothorax associated with pronounced hydrops with intrapleural injection of OK-432. Ultrasound Obstet Gynecol. 2003 Jan;21(1):66–69.
[55] Tanemura M, Nishikawa N, Kojima K, Suzuki Y, Suzumori K. A case of successful fetal therapy for congenital chylothorax by intrapleural injection of OK-432. Ultrasound Obstet Gynecol. 2001 Okt;18(4):371–375.
[56] Okawa T, Takano Y, Fujimori K, Yanagida K, Sato A. A new fetal therapy for chylothorax: pleurodesis with OK-432. Ultrasound Obstet Gynecol. 2001 Okt;18(4):376–377.
[57] Parra J, Amenedo M, Muñiz-Díaz E, Ormo F, Simó M, Vega C, u.a. A new successful therapy for fetal chylothorax by intrapleural injection of maternal blood. Ultrasound Obstet Gynecol. 2003 Sep;22(3):290–294.
[58] Glaser B, Hirsch HJ, Landau H. Persistent hyperinsulinemic hypoglycemia of infancy: long-term octreotide treatment without pancreatectomy. J. Pediatr. 1993 Okt;123(4):644–650.
[59] Rasiah SV, Oei J, Lui K. Octreotide in the treatment of congenital chylothorax. J Paediatr Child Health. 2004 Okt;40(9–10):585–588.
[60] Bulbul A, Okan F, Nuhoglu A. Idiopathic congenital chylothorax presented with severe hydrops and treated with octreotide in term newborn. J. Matern. Fetal. Neonatal. Med. 2009 Dez;22(12):1197–1200.
[61] Au M, Weber TR, Fleming RE. Successful use of somatostatin in a case of neonatal chylothorax. J. Pediatr. Surg. 2003 Juli;38(7):1106–1107.
[62] Goto M, Kawamata K, Kitano M, Watanabe K, Chiba Y. Treatment of chylothorax in a premature infant using somatostatin. J Perinatol. 2003 Okt;23(7):563–564.
[63] BOLES ET, IZANT RJ. Spontaneous chylothorax in the neonatal period. Am. J. Surg. 1960 Juni;99:870–877.
[64] Murki S, Faheemuddin M, Gaddam P. Congenital chylothorax – successful management with chemical pleurodesis. Indian J Pediatr. 2010März;77(3):332–334.
[65] Lahmiti S, Elhoudzi J, Aboussad A. Congenital chylothorax. ScientificWorldJournal. 2009;9:431–434.
[66] Mathur NB, Singh B, Kumar A, Aggarwal SK. Successful treatment of congenital chylothorax using fibrin glue. Indian J Pediatr. 2009 Juli;76(7):758.
[67] Matsukuma E, Aoki Y, Sakai M, Kawamoto N, Watanabe H, Iwagaki S, u.a. Treatment with OK-432 for persistent congenital chylothorax in newborn infants resistant to octreotide. J. Pediatr. Surg. 2009März;44(3):e37–39.
[68] Arafa A, Peitsidis P, Kadir RA. Unusual case of congenital chylothorax. J Obstet Gynaecol. 2009 Jan;29(1):59–60.
[69] Buang SNH, Lai HMA, Batilando MJP, Agarwal PK. Usefulness of octreotide in management of refractory congenital chylothorax in a newborn with terminal deletion of chromosome 7q. Acta Paediatr. 2008;97(Suppl. 459):210–211.
[70] Lim RK, Malik SA. Recurrent pleural effusions in a neonate. Pediatr Emerg Care. 2008 Jan;24(1):41–43.
[71] Smets K. X-linked myotubular myopathy and chylothorax. Neuromuscul. Disord. 2008 Feb;18(2):183–184.
[72] Altuncu E, Akman I, Kiyan G, Ersu R, Yurdakul Z, Bilgen H, u.a. Report of three cases: congenital chylothorax and treatment modalities. Turk. J. Pediatr. 2007 Dez;49(4):418–421.
[73] Yamamoto M, Insunza A, Carrillo J, Caicedo LA, Paiva E, Ville Y. Intrathoracic pressure in congenital chylothorax: keystone for the rationale of thoracoamniotic shunting? Fetal. Diagn. Ther. 2007;22(3):169–171.
[74] Uzuner N, Ölmez D, et al. An infant with bilateral congenital idiopathic chylothorax that required thoracic duct ligation. Turkish Respiratory Journal. 2007;8(3):102–104.
[75] Sousa PR, Leitao H, et al. Idiopathic congenital chylothorax treated with octreotide. J Perinat Med. 2007;35(Suppl. II):270.
[76] Furau G, Luerari S, et al. Congenital chylothorax – case report. J Perinat Med. 35(Suppl. II):159.
[77] Gaede C. Congenital chylothorax: a case study. Neonatal Netw. 2006 Okt;25(5):371–381.
[78] Chen C, Wang T, Chern S, Tzen C, Hsu C, Lee C, u.a. Prenatal diagnosis of congenital chylothorax associated with de novopartial trisomy 12q (12q21.2–>qter). Prenat. Diagn. 2006 Aug;26(8):752–755.
[79] Funke S, Kellermayer R, Czakó M, So J, Kosztolányi G, Ertl T. Congenital chylothorax in Opitz G/BBB syndrome. Am. J. Med. Genet. A. 2006 Mai 15;140(10):1119–1121.
[80] Paget-Brown A, Kattwinkel J, Rodgers BM, Michalsky MP. The use of octreotide to treat congenital chylothorax. J. Pediatr. Surg. 2006 Apr;41(4):845–847.
[81] Mitanchez D, Walter-Nicolet E, Salomon R, Bavoux F, Hubert P. Congenital chylothorax: what is the best strategy? Arch. Dis. Child. Fetal Neonatal Ed. 2006März;91(2):F153–154.
[82] Siu SLY, Lam DSY. Spontaneous neonatal chylothorax treated with octreotide. J Paediatr Child Health. 2006 Feb;42(1–2):65–67.
[83] Lee C, Jan S, Wang T, Chi C. Congenital chylothorax associated with isolated congenital hypoplastic superior caval vein: a case report. Acta Paediatr. 2005 Dez;94(12):1840–1843.
[84] Sahin Y, Aydin D. Congenital chylothorax treated with octreotide. Indian J Pediatr. 2005 Okt;72(10):885–888.
[85] Roehr CC, Jung A, Curcin OA, Proquitte H, Hammer H, Wauer RR. Loculated neonatal chylothorax treated with octreotide: complete recovery while on unrestricted full fat breast milk. Ann. Thorac. Surg. 2005 Nov;80(5):1981–1982; author reply 1982.
[86] Saha PK, Bagga R, et al. Congenital chylothorax presenting as polyhydramnios and fetal hydrops. Department of Obstetrics and Gynaecology and Paediatrics. 2005;39(2):81–83.
[87] Sivasli E, Dogru D, Aslan AT, Yurdakok M, Tekinalp G. Spontaneous neonatal chylothorax treated with octreotide in Turkey: a case report. J Perinatol. 2004 Apr;24(4):261–262.
[88] Hamamoto R, Nishimori A, Izaki T, Okumura K, Ohshiro H, Yamamoto H, u.a. Drainage of subcutaneous lymphatic fluid for the management of respiratory distress in a case of generalized lymphangiectasia in an infant. Pediatr. Surg. Int. 2003 Mai;19(3):204–206.
[89] Brito T, Oliveira C, Sousa L, Barbosa A, Pinho O, Mesquita M, u.a. Congenital chylothorax: a case report. Ultrasound Obstet Gynecol. 2003 Jan;21(1):70–71.
[90] Cardoso D, Tuna M, Abrantes M, dos Santos HG, Da Silva LJ. Congenital chylothorax associated with trisomy X. Eur. J. Pediatr. 2001 Dez;160(12):743.
[91] Chen CP, Chang TY, Wang W. Resolution of fetal bilateral chylothorax and ascites after two unilateral thoracocenteses. Ultrasound Obstet Gynecol. 2001 Okt;18(4):401–402.
[92] Dubin PJ, King IN, Gallagher PG. Congenital chylothorax. Curr. Opin. Pediatr. 2000 Okt;12(5):505–509.
[93] Kugelman A, Gonen R, Bader D. Potential role of high-frequency ventilation in the treatment of severe congenital pleural effusion. Pediatr. Pulmonol. 2000 Mai;29(5):404–408.
[94] Köksal N, Demir S, Okan M, et al. Congenital chylothorax. Turk J Med Sci. 30:307–309.
[95] Ibrahim H, Asamoah A, Krouskop RW, Lewis D, Webster P, Pramanik AK. Congenital chylothorax in neonatal thyrotoxicosis. J Perinatol. 1999 Jan;19(1):68–71.
[96] Takeuchi K, Moriyama T, Oomori S, Masuko K, Maruo T. Management of acute chylothorax with hydrops fetalis diagnosed in the third trimester of pregnancy. Fetal. Diagn. Ther. 1999 Okt;14(5):264–265.
[97] Kessel I, Makhoul IR, Sujov P. Congenital hypothyroidism and nonimmune hydrops fetalis: associated? Pediatrics. 1999 Jan;103(1):E9.
[98] Gonen R, Degani S, Kugelman A, Abend M, Bader D. Intrapartum drainage of fetal pleural effusion. Prenat. Diagn. 1999 Dez;19(12):1124–1126.
[99] Engum SA, Rescorla FJ, West KW, Scherer LR, Grosfeld JL. The use of pleuroperitoneal shunts in the management of persistent chylothorax in infants. J. Pediatr. Surg. 1999 Feb;34(2):286–290.
[100] Murali N, Jana AK, Thomas N, Jeyanthi P. Congenital chylothorax. Indian Pediatr. 1997 Juli;34(7):644–645.
[101] Watson WJ, Munson DP, Christensen MW. Bilateral fetal chylothorax: results of unilateral in utero therapy. Am J Perinatol. 1996 Feb;13(2):115–117.
[102] Shipley CF, Simmons CL, Nelson GH. Intrauterine diagnosis of hydrothorax in a fetus who had a combination chylothorax and pulmonary sequestration after delivery. J Perinatol. 1995 Juni;15(3):237–239.
[103] Hartmann H, Samuels MP, Noyes JP, Goldstraw P, Brookfield DS, Southall DP. A case of congenital chylothorax treated by pleuroperitoneal drainage. J Perinatol. 1994 Aug;14(4):313–315.
[104] Geirsson RT, Pàlsson G. Prenatal thoracocentesis may be lifesaving in congenital chylothorax. J Perinat Med. 1994;22(5):447–448.
[105] Kolben M, Zimmermann A, Schneider KT. [Acute non-immunologic hydrops fetalis with bilateral chylothorax in the 36th week of pregnancy]. Geburtshilfe Frauenheilkd. 1992 Nov;52(11):698–701.
[106] Govaert P, Leroy JG, Pauwels R, Vanhaesebrouck P, De Praeter C, Van Kets H, u.a. Perinatal manifestations of maternal yellow nail syndrome. Pediatrics. 1992 Juni;89(6 Pt 1):1016–1018.
[107] al-Arfaj AL, Upadhyaya P, al-Umran K. Current status of management of neonatal chylothorax. Indian J Pediatr. 1992 Feb;59(1):133–136.
[108] Salem P. A neonate with bilateral refractory chylothorax–a case report. Med. J. Malaysia. 1991 Dez;46(4):376–378.
[109] Huber A, Schranz D, Merz E. [Congenital chylothorax]. Pneumologie. 1991 Nov;45(11):939–941.
[110] Easa D, Balaraman V, Ash K, Thompson B, Boychuk R. Congenital chylothorax and mediastinal neuroblastoma. J. Pediatr. Surg. 1991 Jan;26(1):96–98.
[111] Eddleman KA, Levine AB, Chitkara U, Berkowitz RL. Reliability of pleural fluid lymphocyte counts in the antenatal diagnosis of congenital chylothorax. Obstet Gynecol. 1991 Sep;78(3 Pt 2):530–532.
[112] Hanssler L, Metz KA, Roll C, Hennecke KH. [Primary lymphatic dysplasia in a newborn infant]. Monatsschr Kinderheilkd. 1990 Nov;138(11):772–774.
[113] Zito L, Keszler M. Massive edema and bilateral pleural effusions in a newborn infant. Ann Allergy. 1989 Okt;63(4):277–280.
[114] Carmant L, Le Guennec JC. Congenital chylothorax and persistent pulmonary hypertension of the neonate. Acta Paediatr Scand. 1989 Sep;78(5):789–792.
[115] Booth P, Nicolaides KH, Greenough A, Gamsu HR. Pleuro-amniotic shunting for fetal chylothorax. Early Hum. Dev. 1987 Nov;15(6):365–367.
[116] Jalili F. Medium-chain triglycerides and total parenteral nutrition in the management of infants with congenital chylothorax. South. Med. J. 1987 Okt;80(10):1290–1293.
[117] Meizner I, Carmi R, Bar-Ziv J. Congenital chylothorax–prenatal ultrasonic diagnosis and successful post partum management. Prenat. Diagn. 1986 Juni;6(3):217–221.
[118] Jaffa AJ, Barak S, Kaysar N, Peyser MR. Antenatal diagnosis of bilateral congenital chylothorax with pericardial effusion. Acta Obstet Gynecol Scand. 1985;64(5):455–456.
[119] SarioÄŸlu T, Oto O, Alp M, Güçer S, Ozdemir A, Aytaç A. Neonatal chylothorax. Turk. J. Pediatr. 1985März;27(1):33–37.
[120] Rempen A, Dame W, Jorch G, Pfefferkorn J. [Prenatal diagnosis and therapy of hydro-/chylothorax with fetal hydrops]. Z Geburtshilfe Perinatol. 1984 Apr;188(2):90–93.
[121] Andersen EA, Hertel J, Pedersen SA, Sørensen HR. Congenital chylothorax: management by ligature of the thoracic duct. Scand J Thorac Cardiovasc Surg. 1984;18(3):193–194.
[122] Manning D, O'Brien NG. Congenital pleural effusion with multiple associated anomalies. Ir Med J. 1983 Dez;76(12):497–498.
[123] Sacks LM, Polin JI, Breckenridge J. Congenital chylothorax presenting as hydrops fetalis. A case report. J Reprod Med. 1983 Mai;28(5):341–344.
[124] Azizkhan RG, Canfield J, Alford BA, Rodgers BM. Pleuroperitoneal shunts in the management of neonatal chylothorax. J. Pediatr. Surg. 1983 Dez;18(6):842–850.
[125] Petres RE, Redwine FO, Cruikshank DP. Congenital bilateral chylothorax. Antepartum diagnosis and successful intrauterine surgical management. JAMA. 1982 Sep 17;248(11):1360–1361.
[126] Linder R, Grumbrecht C, Stosiek U, Maier WA, Wolkewitz WU. [Treatment of a prenatally diagnosed chylothorax]. Geburtshilfe Frauenheilkd. 1982 Okt;42(10):720–722.
[127] Rao SS, Karan S. Neonatal pleural effusion due to chylothorax. Indian J Pediatr. 1982 Feb;49(396):149–150.
[128] Coulter JB. Spontaneous chylothorax in a newborn infant. (A case report). Niger Med J. 1979 Feb;9(2):259–263.
[129] Backes CR. Pleural effusion in the neonate caused by congenital chylothorax. J Am Osteopath Assoc. 1978 Sep;78(1):71–73.
[130] Koffler H, Papile LA, Burstein RL. Congenital chylothorax: two cases associated with maternal polyhydramnios. Am. J. Dis. Child. 1978 Juni;132(6):638.
[131] Bensoussan AL, Braun P, Guttman FM. Bilateral spontaneous chylothorax of the newborn. Arch Surg. 1975 Okt;110(10):1243–1245.
[132] Brodman RF, Zavelson TM, Schiebler GL. Treatment of congenital chylothorax. J. Pediatr. 1974 Okt;85(4):516–517.
[133] Doolittle WM, Ohmart D, Egan EA. Congenital bilateral pleural effusions. A cause for respiratory failure in the newborn. Am. J. Dis. Child. 1973März;125(3):435–437.
[134] Barry DM, Watson CE. Unusual causes of respiratory difficulty in the newborn: neonatal chylothorax and neonatal ascites. N. Z. Med. J. 1972 Aug;76(483):102–104.
[135] Mau H, Gdanietz K, Henze E. [Idiopathic chylothorax in early infancy]. Zentralbl Chir. 1972 Feb 19;97(7):211–222.
[136] Said DM, Rosalinas AA, Reichelderfer TE. Chylothorax in the newborn. Report of a case associated with polyhydramnios. Med Ann Dist Columbia. 1968 Okt;37(10):536–540 passim.
[137] Bornhurst RA, Carsky EW. Fetal Hydrothorax. Radiology. 1964 Sep;83:476–479.
[138] Perry RE, Hodgman J, Cass AB. Pleural effusion in the neonatal period. J. Pediatr. 1963;62(6):838–843.
[139] Dahl DJ, Sawyer PN. Chylothorax in the newborn. Arch Pediatr. 1959 Feb;76(2):49–52.
[140] McKendry JBJ, Lindsay WK, Gerstein MC. Congenital defects of lymphatics in infancy. Pediatrics. 1957 Jan;19(1):21–35.
[141] Randolph JG, Gross RE. Congenital chylothorax. AMA Arch Surg. 1957März;74(3):405–419.
[142] Feinerman B, Burke EC, Olsen AM. Chylothorax in infancy. Proc Staff Meet Mayo Clin. 1957 Juni 12;32(12):314–319.
[143] Stirlacci JR. Spontaneous chylothorax in a newborn infant. J. Pediatr. 1955 Mai;46(5):581–586.
[144] Sakula J. Chylothorax in the newborn. Arch. Dis. Child. 1950 Sep;25(123):240–241.
[145] Watson EH, Foster LF. Spontaneous chylothorax in infancy; prognosis and management. Am J Dis Child. 1946 Juli;72:89–94.
[146] Forbes GB. Chylothorax in infancy – Observations on the absorption of vitamins A and D and on the intravenous replacement of aspirated chyle. J. Pediatr. 1944;25(8):191–200.
[147] Wessel MA. Chylothorax in a two-week-old infant with spontaneous recovery. J. Pediatr. 1944;25(3):201–210.
[148] Everhart JK, Jacobs A H. Chylothorax: Review of literature and report of case in newborn infant. J. Pediatr. 1939;15(4):558–562.
[149] Rohleder T. Chylothorax in newborn infants bzw. Über das Vorkommen von Chylothorax beim Neugeborenen. Monatsschr Kinderheilkd. 1937;70:208–211.
[150] Hilgenberg F. Ein Fall von Chylothorax beim Neugeborenen. Monatsschrift für Geburtshilfe und Gynäkologie. 1929;83:225–228.
[151] Le Nué R, Molinaro F, Gomes-Ferreira C, Scheib-Brolly C, Escande B, Kühn P, u.a. Surgical management of congenital chylothorax in children. Eur J Pediatr Surg. 2010 Sep;20(5):307–311.
[152] Diomande D, Husseini K, Meau-Petit V, Dupont C, Picone O, Boileau P. Early-onset pneumothorax indicates poor outcome in newborns with congenital idiopathic chylothorax. Arch. Dis. Child. Fetal Neonatal Ed. 2008 Juli;93(4):F327–328.
[153] Vain NE, Swarner OW, Cha CC. Neonatal chylothorax: a report and discussion of nine consecutive cases. J. Pediatr. Surg. 1980 Juni;15(3):261–265.
[154] Galindo A, Martin P, Puente J, Graneras A, Hernandez-García J. Congenital Chylothorax. Prenatal diagnosis and long-term follow-up. Ultrasound Obstet Gynecol. 2008;32:375.
[155] van Straaten HL, Gerards LJ, Krediet TG. Chylothorax in the neonatal period. Eur. J. Pediatr. 1993 Jan;152(1):2–5.
[156] Rocha G. Pleural effusions in the neonate. Curr Opin Pulm Med. 2007 Juli;13(4):305–311.
[157] Weber AM, Philipson EH. Fetal pleural effusion: a review and meta-analysis for prognostic indicators. Obstet Gynecol. 1992 Feb;79(2):281–286.
[158] Longaker MT, Laberge JM, Dansereau J, Langer JC, Crombleholme TM, Callen PW, u.a. Primary fetal hydrothorax: natural history and management. J. Pediatr. Surg. 1989 Juni;24(6):573–576.
[159. Das A, Shah PS. Octreotide for the treatment of chylothorax in neonates. Cochrane ((BR)) Database Syst Rev. 2010;(9):CD006388.
[160] Buck M. Octreotide for the Management of Chylothorax in Infants and Children. Pediatr Pharm. 2004;10.
[161] Cannizzaro V, Frey B, Bernet-Buettiker V. The role of somatostatin in the treatment of persistent chylothorax in children. Eur J Cardiothorac Surg. 2006 Juli;30(1):49–53.
[162] Mohseni-Bod H, Macrae D, Slavik Z. Somatostatin analog (octreotide) in management of neonatal postoperative chylothorax: is it safe? Pediatr Crit Care Med. 2004 Juli;5(4):356–357.
[163] Garty BZ, Levinson AI, Danon YL, Wilmott R, Douglas SD. Lymphocyte subpopulations in children with abnormal lymphatic circulation. J. Allergy Clin. Immunol. 1989 Okt;84(4 Pt 1):515–520.
[164] Selle JG, Snyder WH, Schreiber JT. Chylothorax: indications for surgery. Ann. Surg. 1973 Feb;177(2):245–249.
[165] Puntis JW, Roberts KD, Handy D. How should chylothorax be managed? Arch. Dis. Child. 1987 Juni;62(6):593–596.
kongenitaler Chylothorax - Octreotid - Somatostatin - Therapie - fetaler Chylothorax - neonataler Chylothorax - Follow up