Cases reported "Chylothorax"

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1/23. noonan syndrome presented with cystic hygroma and chylothorax: case report.

    A cystic hygroma was found in a full-term (39 week-old) male newborn delivered by cesarian section. polyhydramnios was diagnosed by sonography at 21 weeks of gestation. Clinical manifestations at birth, such as respiratory distress, tachypnea and chylothorax were successfully relieved by the insertion of chest tube and medical therapy. Other conditions, which included mild hydronephrosis of left kidney, thickening of aortic and pulmonary valves with mild mitral and tricuspid valves regurgitation, subsided within six months. The cystic hygroma regressed to a webbed neck. In general, the features and clinical manifestations of the present case resembled the criteria of noonan syndrome including various congenital heart defects; webbed neck; chest deformity; a characteristic facial appearance comprising of a broad forehead, ocular hypertelorism, antimongoloid slant of palpebral fissures, low set ears; and bilateral undescended testis etc., suggested by Noonan and other subsequent authors. The outcome of this infant was satisfactory following medical and surgical therapy (chest tube, orchiopexy) and a special dietary regimen.
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2/23. chylothorax complicating radical neck dissection.

    The third reported instance of chylothorax occurring after left radical neck dissection is presented and the literature reviewed. The pathogenesis appears to be lymphatic leakage in the neck with accumulation of chyle in the pleural space in spite of the absence of pneumothorax. The means for entry across an intact pleura is uncertain. The condition can be managed by conservative means consisting of adequate neck drainage and thoracentesis or chest tube drainage. A favorable outcome can be expected.
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keywords = neck
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3/23. Bilateral chylothorax following neck dissection: a new method of treatment.

    chylothorax is a serious condition with a high rate of morbidity that may lead to death. Although it is encountered more frequently with certain thoracic procedures, it is considered to be a rare complication of neck dissection. Different forms of management have been postulated; however, no consensus of treatment has been achieved. A case of severe bilateral chylothorax that developed after bilateral neck dissection in a patient with laryngeal carcinoma is presented. somatostatin injection was successful after total parenteral nutrition failed to control the chylothorax. On the basis of this case and the review of the literature discussed here, we advocate the use of somatostatin with other conservative measures in the management of chylothorax.
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keywords = neck
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4/23. Bilateral chylothorax after left radical neck dissection.

    Bilateral chylothorax, as a complication of neck dissection, is very rare as evidenced by the 11 cases reported in the literature up to date. We present an additional case of bilateral chylothorax following a left radical neck dissection and concomitant chylous neck fistula. This case was successfully treated by chest drainage and total parenteral nutrition. early diagnosis of chylothorax is urged due to the consequences on metabolism and respiratory conditions. Management by aspiration drainage is usually sufficient to control pleural effusions.
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keywords = neck
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5/23. Bilateral chylothorax following radical neck dissection.

    Bilateral chylothorax as a complication of radical neck dissection is extremely rare, but it is potentially serious and sometimes fatal. We found only 14 cases reported in the English literature. Here, we report a case of bilateral chylothorax following right modified and left radical neck dissections that was successfully treated with conservative management.
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keywords = neck
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6/23. EXIT procedure: a case report.

    The EXIT (Ex-Utero Intrapartum Treatment) procedure is an extremely valuable tool in providing time to secure the airway in infants with large fetal neck masses and abnormalities of the upper airway which impede resuscitation. The fetus is partially delivered while maintaining utero-placental-fetal circulation. We report the use of this technique in a case of huge cystic hygromas of the neck and chest due to a nuchal bleb-lethal dysplasia. Although severe pulmonary hypoplasia precluded an optimal outcome, this report shows that this procedure is technically feasible. We believe this to be the first case performed and reported in louisiana.
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keywords = neck
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7/23. chylothorax fluid autoinfusion in a chronic hemodialysis patient.

    A large left-sided pleural effusion occurred in a 12-year-old end-stage renal disease patient undergoing chronic hemodialysis (HD). The fluid had physical and laboratory characteristics of chylothorax (CHTX) and was probably related to the multiple HD accesses placed in the neck area. Initially, thoracenteses were performed and the fluid discarded. Subsequently, a permanent drainage catheter placed in the left hemithorax was connected to a syringe with a stopcock, and from here to the arterial port of the HD catheter. One liter of CHTX fluid was removed on dialysis days three times weekly, for 7.5 weeks, and directly re-infused into the patient in a closed sterile circuit. A total of about 20 l was safely returned to the patient. The procedure was well tolerated and provided time until the CHTX resolved spontaneously. It is recommended that in similar clinical settings re-infusion of CHTX fluid should be performed to prevent the loss of protein-/T-cell-rich fluid.
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ranking = 0.5
keywords = neck
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8/23. Peripheral parenteral nutrition in a case of chyle leak following neck dissection.

    chylothorax is an uncommon condition which is potentially life-threatening if untreated. The following case study of a 75-year-old man with chyle leak following surgery shows how prompt dietetic action prevented further compromise in immune function and nutritional status. Dietetic recommendation to minimize enteral intake rapidly stopped chyle flow and promoted wound closure. Peripheral parenteral nutrition (PPN) was administered in order to prevent malnutrition. There is limited literature available for evidence of best practice for cases of chyle leakage, however, this particular case demonstrates PPN should be considered despite the potential risks.
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keywords = neck
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9/23. somatostatin treatment of massive lymphorrhea following excision of a lymphatic malformation.

    Postoperative lymphorrhea is a serious and occasionally lethal complication of neck dissection and cardiothoracic surgery. Management is not standardized, but usually centers around diet modification, drainage, pressure dressings, and reoperation. We report the successful use of the long acting somatostatin analogue octreotide in the management of massive lymphorrhea complicating excision of a large cervicomediastinal lymphatic malformation in an infant. Based on this report and a review of the available literature, we advocate the early consideration of somatostatin and its analogues in the control of lymphorrhea.
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keywords = neck
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10/23. Detection of chylothorax and cervical cystic hygroma in hydrops fetalis using lymphoscintigraphy.

    A 2-month-old boy was diagnosed as having nonimmune hydrops fetalis. lymphoscintigraphy of the lower extremities revealed accumulation of radiotracer in the middle mediastinum on both sides indicating leakage of lymphatic flow from the thoracic duct at 1 hour. There was visualization of radiotracer in both lung fields suggestive of chylothorax. radioactivity was noted accumulating in the neck consistent with the areas of cystic hygromas on the 4-hour image. Visualization of the cystic hygromas was believed to be the result of feeding of the lymphatic flow from the tributaries of the right lymphatic trunk and thoracic duct or aberrant lymphatic drainage pathways.
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