Successful Intranodal Lymphangiography for Refractory Chylothorax in a Neonate with Congenital Heart Disease

Abstract

Interventional radiology (IVR) is a new effective therapeutic strategy for chylothorax. However, reports of IVR applied in children, especially neonates, are limited. Herein, we report the case of a 1-day-old neonate with complete transposition of the great arteries, ventricular septal defect, and right aortic arch. She underwent pulmonary artery banding at 13 days of age, and during thoracotomy, chylothorax was observed. We started tube feeding on postoperative day 3. On postoperative day 6, a considerable amount of chyle (170 mL/day) was drained; hence, a conservative treatment was introduced but was subsequently found to be ineffective. We performed intranodal lymphangiography (IL) on postoperative day 11. Consequently, the chylothorax improved 3 days later. Therefore, IL was effective for the management of neonatal postoperative chylothorax. In conclusion, IL is less invasive than surgical treatment and is effective against refractory chylothorax. However, further case reports of children and neonates who have undergone IL are necessary to confirm these findings.