Congenital chylothorax. lessons from reported cases

Chylothorax is the accumulation of chyle—lymphatic fluid rich in triglycerides—in the pleural cavity. This results in pleural effusion. Congenital chylothorax (CC) is the most common cause of neonatal pleural effusions. It occurs in approximately 1 in 25,000 live births and affects female infants more often .CC is often idiopathic but can also be part of genetic syndromes such as Noonan, Turner, Down, Ehlers-Danlos, and Costello syndromes More commonly, it arises in non-syndromic cases. These are due to congenital malformation or injury of the thoracic lymphatic duct. The duct may be occluded, underdeveloped, or traumatically disrupted during delivery.

Diagnosis is typically confirmed by analysis of pleural fluid, which reveals a high concentration of lymphocytes, proteins (e.g., albumin, antibodies, coagulation factors), lipids, and other biologically active components. Given the potential loss of essential immune and nutritional elements, close monitoring and replacement are critical. Management remains challenging, and although surgical options exist, a conservative, stepwise therapeutic approach is widely recommended as the initial strategy.

Dr.Al-Sufayan, is a senior physician specialized in neonatal-perinatal medicine. Currently working at Dr. Sulaiman Alhabib Hospital in AlKhobar city, Saudi Arabia, one of the largest healthcare private corporate. He completed fellowship training in neonatal-perinatal medicine at university. of Manitoba, Canada. He obtained research methodology diploma from American university of Beirut in 2012. In 2016, he successfully completed Executive Master of Business Administration. His passion for quality of care and patient safety thrives over two decades of clinical practice to be one of the national solo medical surveyors in the Saudi central board for accreditation of healthcare institutions. He is a guest speaker in national and international conference. He published articles medical journals as an author or coauthor.