Mahmut TOKUR, Tahir DALKIRAN, Kadir SÖYLEMEZ, Fatih KARAOKUR, Mehmet DAVUTOĞLU, Yalçın GÖKSÜĞÜR

Spontaneous Chylothorax (A Case Report)

Şilotoraks, duktus torasikus ya da dallarının bozulması ya da tıkanıklığına bağlı olarak plevral aralığa şilöz sıvının sızmasıdır. Öncesinde herhangi bir yakınması bulunmayan 3,5 yaşında erkek hasta, öksürük ve hırıltılı solunum şikayetleriyle başvurdu. Akciğer grafisinde sol akciğerde konsolidasyon ile birlikte plevral efüzyon saptandı. Kapalı sualtı drenaja alınan hastanın efüzyon sıvısının görünümü süt beyaz renkte, pH 7, dansite 1015, trigliserit 2101 mg/dl, glikoz 168 mg/dl, lökosit 590 mm3 bulundu. Plevral efüzyon sıvısı kültüründe üreme olmadı. Bu bulgularla hastaya şilotoraks tanısı konuldu. Yağdan fakir diyetle birlikte somatostatin 3 ?gr/kg/saat başlandı. Somatostatin tedavisine 2 hafta devam edilen hasta 25. günde toraks tüpü çıkarılarak taburcu edildi. Şilotoraksın çok nadiren de olsa spontan gerçekleşebileceği, tedavide somatostatin kullanımının cerrahi müdahale ihtiyacını azaltabileceği vurgulandı.

Spontan Şilotoraks (Bir Olgu Sunumu)

Chylothorax is caused by the distruption or obstruction of the thoracic duct or its tributaries that result in leakage of chyle into the pleural space. A 3.5-year-old male patient without significant past medical history was admitted to the outpatient clinic of our hospital with persistent coughing. The initial chest radiograph demonstrated consolidation and effusion in the left lung upon which we performed thoracentesis. The pleural fluid had milk-white color. The biochemical analysis showed that its density was 1015 with pH: 7, glucose: 168 mg/dl, triglyceride: 2101 mg/dl, and WBC: 590/mm3. We started the treatment by offering a low-fat diet and somatostatin 3 ?gr/kg/h. The chest tube was removed on the 25th day after the cessation of chylous pleural fluid from the tube in addition to the improvement that was visible on the chest radiograph; the patient was discharged. We would like to emphasize that chylothorax may occur very rarely but spontaneously and the use of somatostatin therapy may reduce the need for surgical intervention.

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