SHIRAKAMI, Eri Division of Plastic and Reconstructive Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.
Rationale: Chylothorax remains a poorly understood phenomenon, and no optimal treatment or guidelines have been established. This is the first report of treating congenital chylothorax and lymphedema in a low-birth-weight infant by lymphovenous anastomosis (LVA).
Patient concerns: We report a case of successful LVA for persistent congenital chylothorax and lymphedema resistant to other conservative therapies.
Diagnosis: The diagnosis of chylothorax was confirmed by the predominance of lymphocytes in the pleural fluid draining from the chest tube. In addition, the infant developed oliguria and generalized lymphedema.
Interventions: LVA under local anesthesia combined with light sedation was performed at his medial thighs and left upper arm.
Outcomes: Although his subcutaneous edema markedly improved, the decrease in chest tube drainage was gradual. No additional treatment was required.
Lessons: LVA is of considerable value as a surgical treatment option in the setting of persistent congenital chylothorax and lymphedema, because LVA is a less invasive procedure.
Hagerstown, Md : Lippincott Williams & Wilkins
Faculty of Medicine