Pleuroperitoneal Shunt for a Child With Pleural Effusion

Abstract

Although some authors report the usefulness of a pleuroperitoneal shunt for children, the surgical procedure of shunt implantation has not been established yet because of the size of shunt. A pleuroperitoneal shunt was implanted in a 4-year-old girl with idiopathic pleural effusion. She had chylothorax and chyloperitoneum during her neonatal period. The effusion was eliminated using a medium-chain triglyceride (MCT) formula. Then, after 4 years, dyspnea suddenly appeared. Intubation and thorax drainage were required for severe right pleural effusion. The effusion was transudative, but diuretic administration and drainage were ineffective. Lymphoscintigraphy showed a normal lymphatic system from the chyle cistern to the thoracic duct and venous angle. This means that pleural effusion can effectively pass through the lymphatic system from the peritoneum. After the implantation of the pleuroperitoneal shunt, she became free from thoracic drainage. The shunt implantation procedure is relatively easy and especially useful for transudative pleural effusion. We report this case with reference to some reports in the literature.