Lethal chylothoraces due to superior vena caval thrombosis in infants

An unusual etiology, probably iatrogenic, for chylothoraces in the newborn period was recently noted. Three tiny premature infants, all of whom subsequently died, developed massive bilateral chylothoraces. These infants had had prolonged hyperalimentation using jugular central venous catheters for severe gastrointestinal problems and malnutrition. All developed superior vena caval thrombosis, two with overt superior vena caval syndromes. Two had venograms that showed extension of thrombus into the innominate veins to the confluence of the jugular and subclavian veins, at the site of drainage of the lymphatic channels of the thorax. The relationship between superior vena caval an innominate vein thrombosis and chylothoraces in discussed and an important pitfall in the radiologic evaluation is emphasized.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				V. Cannizzaro, B. Frey, and V. Bernet-Buettiker The role of somatostatin in the treatment of persistent chylothorax in children. Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 49 - 53. [Abstract] [Full Text] [PDF]

				P. Monagle, A. Chan, P. Massicotte, E. Chalmers, and A. D. Michelson Antithrombotic Therapy in Children*: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy Chest, September 1, 2004; 126(3_suppl): 645S - 687S. [Abstract] [Full Text] [PDF]

				C. Male, P. Chait, M. Andrew, K. Hanna, J. Julian, and L. Mitchell Central venous line-related thrombosis in children: association with central venous line location and insertion technique Blood, June 1, 2003; 101(11): 4273 - 4278. [Abstract] [Full Text] [PDF]

				M. E. Andrew, P. Monagle, G. deVeber, and A. K.C. Chan Thromboembolic Disease and Antithrombotic Therapy in Newborns Hematology, January 1, 2001; 2001(1): 358 - 374. [Abstract] [Full Text] [PDF]

				P. Monagle, A. D. Michelson, E. Bovill, and M. Andrew Antithrombotic Therapy in Children Chest, January 1, 2001; 119(1_suppl): 344S - 370S. [Full Text] [PDF]

				J. Hirsh and J. Hoak Management of Deep Vein Thrombosis and Pulmonary Embolism : A Statement for Healthcare Professionals From the Council on Thrombosis (in Consultation With the Council on Cardiovascular Radiology), American Heart Association Circulation, June 15, 1996; 93(12): 2212 - 2245. [Full Text]

				M. C. Robotin, B. D. Edis, R. G. Weintraub, A. Pawade, and T. R. Karl Heart Transplantation for Chyloptysis After Fontan Operation Ann. Thorac. Surg., June 1, 1995; 59(6): 1570 - 1571. [Abstract] [Full Text]

				W. V. Raszka Jr, F. R. Smith, and S. R. Pratt Superior Vena Cava Syndrome in Infants Clinical Pediatrics, April 1, 1989; 28(4): 195 - 198. [Abstract] [PDF]

				R.L. Bucciarelli and R. Jaffe Noninvasive Evaluation of Superior Vena Caval and Right Atrial Thrombosis Complicating Central Hyperalimentation Clinical Pediatrics, April 1, 1983; 22(4): 302 - 303. [PDF]