A case report of successful therapy for neonatal chylothorax with pneumothorax by conservative medical treatment

BACKGROUND: Neonatal chylothorax is a rare disease that causes breathing difficulties in newborns and is one of the most common causes of pleural effusion during the neonatal period. Neonatal chylothorax is often caused by lymph leakage into the chest and can be divided into the following 5 types: congenital chylothorax, traumatic chylothorax, postoperative chylothorax, embolic chylothorax, and spontaneous chylothorax. Among them, spontaneous chylothorax is the most common type of neonatal chylothorax and has unknown causes. The mortality rate of neonatal chylothorax is relatively high, but there are still no unified management guidelines or expert consensus on its treatment. CASE DESCRIPTION: In this article, we report the case of a child in whom a large amount of pleural effusion on both sides of the thorax was first found 3 days before delivery. During labor, extrauterine intrapartum treatment (EXIT) was administered to complete the pleural effusion puncture and drainage but was complicated by the right pneumothorax. After delivery, the patient was cured and discharged from the hospital, but required high-frequency oscillating respiratory support, continuous chest drainage, and nutritional management. CONCLUSIONS: The effective control of the pleural effusion suction speed may reduce pneumothorax complications. Infection is the most common complication of neonatal chylothorax. Thus, the multidisciplinary collaborative diagnosis and EXIT may pave a new way for the efficient treatment of neonatal chylothorax. This successful case may serve as a reference for the management of children with congenital chylothorax.