PMID: 9434996Jan 22, 1998Paper

Chylothorax as a manifestation of child abuse

Pediatric Emergency Care
S L GeismarJ J Chiaro

Abstract

Chylothorax presenting in a child without a well defined etiology may be a manifestation of child abuse. We recently observed a child with bilateral chylothoraces who demonstrated coexisting nonaccidental injuries. It is our intention to alert physicians to the association of chylothorax with nonaccidental trauma and review the prior medical literature. Case report. Pediatric emergency department and intensive care unit. An 18-month-old female child who presented with respiratory distress and failure to thrive. Diagnostic and therapeutic thoracentesis. Skeletal survey and radionuclide bone scan. Nutritional support. Pleural fluid is characterized as chylous if it contains significant numbers of lymphocytes and lipid. Unexplained fractures of the ribs and long bones in varying stages of healing are considered nonaccidental. Failure to thrive may be considered nonorganic when nutritional support alone results in significant weight gain. Our patient presented with respiratory distress of one-week duration and failure to gain weight during the prior five months. The chest radiograph demonstrated bilateral pleural effusions, which were aspirated. The aspirate contained 1733 cells/mm3 (98% lymphocytes), which were lipid laden. The tr...Continue Reading

Citations

Apr 5, 2003·The Journal of Emergency Medicine·Brian F Chinnock
May 19, 2012·The Surgical Clinics of North America·Christopher Guidry, Eugene D McGahren
Sep 22, 2015·Pediatrics International : Official Journal of the Japan Pediatric Society·Yasuhiro IchikawaHiroyuki Shiro
Nov 3, 2009·Paediatric Respiratory Reviews·Manuel Soto-Martinez, John Massie
Jun 5, 2007·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·James D Anderst

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