Oral sildenafil, an alternative treatment for congenital chylothorax - Case presentation and review of the literature

Background. Congenital chylothorax is a rare but potentially lethal condition characterized by the accumulation of chyle in the pleural cavity during fetal life. Etiology is vast, and treatment is challenging. Thus, different approaches are followed, but no standardized guidelines are available. The general strategy is to initiate supportive, conservative therapy, and as needed, more invasive procedures may be used in order to reduce the chylous accumulation and lead time for the lymphatic system to develop or heal. Octreotide is the most frequently used drug in congenital chylothorax treatment. In the lack of somatostatin analog, other medications, like sildenafil, were used in several cases with success. We present a case of a late preterm infant who responded positively to oral sildenafil treatment. Conclusion. There is a considerable need for randomized studies to achieve standardized therapeutic algorithms.