Congenital Idiopathic Chylothorax In A Jamaican Neonate: Management Challenges

Congenital idiopathic chylothorax is the accumulation of chylous fluid in the pleural space. Typically occurs in the late third trimester and possible explanations are malformation and leakage from the thoracic duct. We report an index case in a Jamaican neonate diagnosed with polyhydramnios and bilateral pleural effusions by routine sonography at 34 weeks gestational age. Antenatal diagnostic work up done aimed to exclude hydrops fetalis and its numerous aetiologies. We highlight our limitations.At birth elective mechanical ventilation was essential and bilateral thoracostomy tubes placed were both diagnostic and therapeutic. The infant received a specialized diet exclusively for 8 weeks and regular feeds were tolerated at 8 weeks. The rarity of this condition, diagnostic limitations such as ready availability of karyotyping, limited facilities for antenatal intervention may present surmountable management challenges.