Volume 10, Issue 4 (2025)
SJMR 2025, 10(4): 191-196 |
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Salehi S, Abedini Z, Mohammadian H, Sanaye Naderi M, Nateghi M R. Congenital Chylothorax in an Extreme Preterm Infant. SJMR 2025; 10 (4) : 4
URL: http://saremjrm.com/article-1-382-en.html
URL: http://saremjrm.com/article-1-382-en.html
Shima Salehi1 
, Zohreh Abedini1 , Hadis Mohammadian1 , Maryam Sanaye Naderi2 , Mohammad Reza Nateghi *2 
, Zohreh Abedini1 , Hadis Mohammadian1 , Maryam Sanaye Naderi2 , Mohammad Reza Nateghi *2
1- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Sciences, Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Sciences, Tehran, Iran. & Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Sciences, Tehran, Iran. & Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran.
Abstract: (4 Views)
Introduction: Congenital chylothorax is a rare but clinically significant cause of pleural effusion in the neonatal period, particularly among preterm infants, in whom it may be associated with severe respiratory, metabolic, and infectious complications. This condition results from leakage of lymphatic fluid into the pleural space, and timely diagnosis and appropriate management play a crucial role in determining patient outcomes. Given its low incidence and complex clinical presentation, reporting individual cases may contribute to increased clinical awareness and improved diagnostic and therapeutic strategies.
Case Presentation: We report a case of an extreme preterm female neonate born at 27 weeks of gestation with a birth weight of 900 grams, who was admitted to the neonatal intensive care unit of Sarem Women’s Hospital (Tehran, Iran) due to severe respiratory distress immediately after birth. Following initiation of enteral feeding, the infant developed worsening respiratory symptoms, and imaging studies revealed a pleural effusion. Thoracentesis yielded milky-appearing pleural fluid, and laboratory analysis demonstrated elevated triglyceride levels and lymphocytosis, confirming the diagnosis of neonatal chylothorax. Despite conservative management, including cessation of enteral feeding, total parenteral nutrition, chest tube placement, and surgical consultation, surgical intervention was not feasible due to extreme prematurity and very low birth weight. During the subsequent hospital course, the patient developed sepsis and pneumonia and ultimately succumbed to these complications.
Conclusion: Congenital chylothorax, particularly in very preterm infants, represents a significant diagnostic and therapeutic challenge and may be associated with poor outcomes. Worsening respiratory distress following the initiation of enteral feeding should raise clinical suspicion for this condition. Early diagnosis and a multidisciplinary management approach may contribute to improved clinical outcomes. This case highlights the importance of considering chylothorax as a critical differential diagnosis in preterm neonates presenting with pleural effusion.
Case Presentation: We report a case of an extreme preterm female neonate born at 27 weeks of gestation with a birth weight of 900 grams, who was admitted to the neonatal intensive care unit of Sarem Women’s Hospital (Tehran, Iran) due to severe respiratory distress immediately after birth. Following initiation of enteral feeding, the infant developed worsening respiratory symptoms, and imaging studies revealed a pleural effusion. Thoracentesis yielded milky-appearing pleural fluid, and laboratory analysis demonstrated elevated triglyceride levels and lymphocytosis, confirming the diagnosis of neonatal chylothorax. Despite conservative management, including cessation of enteral feeding, total parenteral nutrition, chest tube placement, and surgical consultation, surgical intervention was not feasible due to extreme prematurity and very low birth weight. During the subsequent hospital course, the patient developed sepsis and pneumonia and ultimately succumbed to these complications.
Conclusion: Congenital chylothorax, particularly in very preterm infants, represents a significant diagnostic and therapeutic challenge and may be associated with poor outcomes. Worsening respiratory distress following the initiation of enteral feeding should raise clinical suspicion for this condition. Early diagnosis and a multidisciplinary management approach may contribute to improved clinical outcomes. This case highlights the importance of considering chylothorax as a critical differential diagnosis in preterm neonates presenting with pleural effusion.
Article number: 4
Article Type: Case Report |
Subject:
neonates
Received: 2026/01/1 | Accepted: 2026/01/8 | Published: 2026/02/14
Received: 2026/01/1 | Accepted: 2026/01/8 | Published: 2026/02/14
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