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Publication
Quilotorax Congénito: Controvérsias
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Advisor(s)
Abstract(s)
RESUMO
O quilotórax é o derrame pleural neonatal
mais frequente, apesar de representar
um diagnóstico raro. A sua etiologia
é na maioria dos casos traumática
pós-cirúrgica, estando também descrita
a associação a cromossomopatias, situações
que condicionem síndrome da veia
cava superior ou casos de anomalias do
sistema linfático. Existe no entanto um
grupo cuja etiologia permanece desconhecida.
Relata-se o caso clínico de quilotórax
congénito bilateral de apresentação
pré-natal, para o qual foi instituído tratamento
conservador, incluindo o octreótido,
um fármaco utilizado habitualmente
no tratamento do quilotórax traumático
mas ainda com poucas descrições no
quilotórax congénito. A evolução foi favorável,
de acordo com a história natural da
doença, permanecendo algumas dúvidas
quanto à contribuição do octreótido, bem
como quanto ao plano de monitorização
e terapêutica numa patologia que é rara
e cuja literatura apresenta abordagens
muito díspares.
ABSTRACT Chylothorax is the most common cause of pleural effusion in the neonatal period, although it is a rare situation. This condition usually results from a lesion of the thoracic duct after a surgery, but is also associated with chromosomal abnormalities and with abnormalities of the lymphatic system. However some have no identifiable cause. We report a case of a congenital bilateral chylothorax that had a prenatal presentation, treated with a conservative approach, using octreotide, a drug used in the treatment of the traumatic chylothorax, but with phew descriptions in the congenital chylothorax. The outcome was good, according to the natural history of this condition, but there remain some doubts regarding the role of the octreotide, as well as concerning the adjuvant therapeutic in a scenario that is rare and which available data presents very different approaches.
ABSTRACT Chylothorax is the most common cause of pleural effusion in the neonatal period, although it is a rare situation. This condition usually results from a lesion of the thoracic duct after a surgery, but is also associated with chromosomal abnormalities and with abnormalities of the lymphatic system. However some have no identifiable cause. We report a case of a congenital bilateral chylothorax that had a prenatal presentation, treated with a conservative approach, using octreotide, a drug used in the treatment of the traumatic chylothorax, but with phew descriptions in the congenital chylothorax. The outcome was good, according to the natural history of this condition, but there remain some doubts regarding the role of the octreotide, as well as concerning the adjuvant therapeutic in a scenario that is rare and which available data presents very different approaches.
Description
Keywords
Quilotórax congénito octreótido Chylothorax congenital
Citation
Nascer e Crescer 2006; 15(1): 33-36