JR Pan, LP Shi, MY Sun

Abstract

We described the treatment and therapeutic effect of chemical pleurodesis with erythromycin for the three refractory neonates. Chylothorax is a comparatively rare disease with an incidence ranging from 1 in 6000 to 1 in 10000 and a male to female predominance (2:1). Underlying cause is usually attributable to 1 of 4 categories: malignancy, trauma (including surgery), miscellaneous disorders, and idiopathic. We described three neonates who suffered from idiopathic congenital chylothorax. Although rare, congenital idiopathic chylothorax is the most common form of pleural effusion in neonates. Significant long-term morbidity and mortality were reported because of immunologic, metabolic, and nutritional complications in neonates. Many forms of conservative therapy are not always effective in treating idiopathic congenital chylothorax. In our three reported cases, conservative therapy including the provision of total parenteral nutrition and repeated drainage of pleural effusion failed. Eventually all the cases were successfully treated by chemical pleurodesis with erythromycin.