Newborn With 21 Trysomy and Chilous pleural Effusion

K. Lomauri
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Abstract

Neonatal chylothorax results from the accumulation of chyle in the pleural space and may be either congenital or an acquired condition. Congenital chylothorax is most likely due to abnormal development or obstruction of the lymphatic system and often associated with hydropsfetalis. It can be idiopathic or may be associated with various chromosomal and other genetic abnormalities. It is important to identify infants with chylothorax, as there are specific issues that need to be addressed in the management of these patients. In the neonate, chylous effusion is a common cause of pleural effusions and characterized as an exudate because of the high protein and lipid content once the infant is fed. The fluid will be clear/yellow to slightly cloudy in the unfed state and will quickly become milky following feeding, as chylomicrons appear in the fluid. Lymphocytes predominate in the differential cell count of chyle. The volume of fluid output can be high, and management can be challenging. We present a case of newborn with 21 trisomy who developed moderate RDS, chest X-ray and US reveal pleural effusion on right side, rapid intervention was made before deterioration, requiring intensive life-saving measures. We review the common manifestations of congenital chylotoraxes and emphasize the importance of early diagnosis and intervention in preventing devastating outcomes from this condition.
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新生儿有21例Trysomy和紫色胸腔积液
新生儿乳糜胸是由乳糜积聚在胸膜间隙引起的,可能是先天性的,也可能是后天的。先天性乳糜胸最可能是由于淋巴系统的异常发育或阻塞,并常与胎儿积水有关。它可能是特发性的,也可能与各种染色体和其他遗传异常有关。确定乳糜胸婴儿是很重要的,因为在这些患者的管理中有一些具体的问题需要解决。在新生儿中,乳糜积液是胸腔积液的常见原因,一旦婴儿被喂食,乳糜积液就以渗出物为特征,因为乳糜积液中含有高蛋白和脂质。未喂食时,乳糜积液呈透明/黄色至微浑浊,喂食后,乳糜微粒出现在乳糜积液中,乳糜积液很快变成乳白色。淋巴细胞在乳糜的细胞计数中占主导地位。产液量可能很大,管理起来也很有挑战性。我们报告了一例21三体新生儿,出现中度RDS,胸部x线和US显示右侧胸腔积液,在恶化前迅速干预,需要加强抢救措施。我们回顾了先天性乳糜瘘的常见表现,并强调早期诊断和干预的重要性,以防止这种情况的破坏性后果。
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