Tratamiento del quilotórax posquirúrgico con octreótido

  1. Esther Aleo Luján
  2. M.M. Urán Moreno
  3. Kay Boris Brandstrup
  4. Jesús López Herce Cid
  5. José Luis Zunzunegui
Revista:
Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )

ISSN: 1695-4033 1696-4608

Any de publicació: 2003

Volum: 58

Número: 4

Pàgines: 390-392

Tipus: Article

Altres publicacions en: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )

Resum

Chylothorax is an infrequent complication of cardiac surgery in children. Most patients respond to a low-fat diet or to parenteral nutrition, but pleuroperitoneal drainage or thoracic duct ligature is sometimes required. We present the case of a 3-year-old girl with Down syndrome and complexatrioventricular canal defect who presented chylothorax 22 days after the Glenn procedure with bidirectional pulmonarycava fistula. Low-fat diet and parenteral nutrition produced no improvement and the patient was treated with octreotide 1-2 mcg/kg/min in intravenous continuous perfusion, which produced remission of chylothorax. Subsequently, 20 mcg/kg/day of octreotide was subcutaneously administered in three doses, allowing progressive dietary normalization, without recurrence of chylothorax or adverse effects. In conclusion, octreotide is well tolerated and produces few adverse effects. It could be used as a therapeutic alternative in chylothorax refractory to conservative treatment.