Chylothorax is a rare disease (1-2% of pleural effusions), with a prevalence between 1/8600 and 1/15,000 births. It is characterized by the presence of chyle in the pleural cavity. Three categories of chylothorax are known: congenital, idiopathic or traumatic (usually postoperative) chylothorax. We report the observation of a 3-year-old child with idiopathic chylothorax revealed by respiratory symptoms, with pleural effusion and ipsilateral lung collapse on chest x-ray and CT. Cytology and chemical analysis of pleural fluid showed exudative fluid with a chyous appearance, high cell count (2800 cells/mm3), lymphocyte predominance (98%), and culture was sterile. Chylothorax is usually revealed by dyspnea, but also by nausea, vomiting, anorexia and/ or malnutrition. The diagnosis is suspected when the puncture brings back a milky liquid, confirmed by the presence of a triglyceride level greater than 1.2 mmol/ L and number of cells greater than 1000 cells/ mL, with lymphocyte predominance. Treatment of chylothorax can be conservative or surgical when conservative management fails and aims to stop permanent chyle leakage.
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Meryem et al. (2024) studied this question.
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