RESUMO
It has been well recognized that intra-thoracic surgery is a major cause of chylothorax in the newborn period; however, catheter-related thrombosis could also be a cause. We report a preterm baby who presented with right chylothorax secondary to venous thrombosis postinadvertent right internal jugular vein catheterization. The complication resolved with drainage, catheter removal and low molecular weight heparin. The literature on neonatal chylothorax and thrombosis and case reports reporting thrombosis-related chylothorax that have been successfully treated with anticoagulation are reviewed.
Assuntos
Anticoagulantes/uso terapêutico , Cateterismo Venoso Central/efeitos adversos , Quilotórax/tratamento farmacológico , Heparina/uso terapêutico , Doenças do Prematuro , Quilotórax/etiologia , Feminino , Humanos , Recém-Nascido , Veias Jugulares , Masculino , Avaliação de Resultados em Cuidados de Saúde , Gravidez , Complicações na Gravidez , Trombose Venosa/complicações , Trombose Venosa/etiologiaRESUMO
OBJECTIVES. To clarify the use of ultrasonography by determining the frequency of developmental dysplasia of the hip among breech-presented Chinese neonates in Hong Kong. DESIGN. Prospective case series. SETTING. Regional hospital, Hong Kong. PATIENTS. All breech-presented Chinese neonates born during January 2008 to June 2009 were included (except premature neonates). They were examined clinically from birth till the age of 1 year. Ultrasound of the hips was performed at the age of 2 weeks, and X-ray of the pelvis at the age of 1 year. RESULTS. A total of 209 breech-presented neonates were born during the study period; 110 neonates completed all necessary investigations and follow-up. Among the latter, there were three neonates with developmental dysplasia of the hip warranting treatment, which amounted to a frequency of 2.7%. CONCLUSION. Developmental dysplasia of the hip among breech-presented Chinese babies is only slightly less common than in corresponding populations in other regions in the world. Since early diagnosis is important, ultrasonography screening in high-risk cases such as those with breech presentation may be useful.
Assuntos
Apresentação Pélvica , Luxação Congênita de Quadril/epidemiologia , Triagem Neonatal/métodos , Feminino , Seguimentos , Luxação Congênita de Quadril/diagnóstico por imagem , Hong Kong/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Estudos Prospectivos , UltrassonografiaRESUMO
Chylothorax is the most common cause of pleural effusion causing respiratory distress in the neonate. Cases unresponsive to conservative management usually require surgery. We report a case of spontaneous neonatal chylothorax where surgery was avoided with the compassionate trail of octreotide. The chylothorax resolved promptly with no observed side effects. After reviewing the literature reporting the use of octreotide in the neonatal period, we found that neonates with isolated spontaneous chylothorax might be viewed as a group different from those with major cardiac malformations. They are at a lower risk for adverse effect of octreotide and lower threshold for commencement of octreotide may benefit them most.