Challenges of Diagnosis and Management of Congenital Chylothorax in a Low-Resource Setting: A Case Report

Abstract

Chylothorax is a form of pleural effusion. In the neonate, it may be diagnosed in the antenatal or postnatal period. Congenital forms of chylothorax are due to abnormal development or obstruction of the lymphatic system and may be associated with hydrops foetalis; it may also be idiopathic or associated with chromosomal anomalies. The diagnosis is usually based on biochemical analysis of pleural aspirate, and the interpretation of the biochemical parameters depends on whether the baby is feeding. The treatment involves dietary modification, the use of different types of drugs, chest tube drainage, pleurodesis or some other surgical intervention. There are no clinical trials to document the most effective treatment modality. Intrauterine interventions have been reported in some cases. We report a case of neonatal chylothorax to document the diagnostic challenges and management outcomes in a resource-limited setting.