Oktreotid ile Tedavi Edilen Konjenital Şilotoraks Olgusu

Yıl 2015, , 68 - 71, 01.06.2015

Özmert Muhammet Ali Özdemir Hacer Ergin Kazım Küçüktaşçı Özlem Şahin Nergül Çördük Eda Karadağlı Başak Yıldırım

https://doi.org/10.4274/jcp.83803

Öz

Konjenital şilotoraks plevra boşluğunda şilöz sıvı birikmesidir. Yenidoğan döneminde plevral efüzyonun en sık sebebidir. Şilotoraksın geleneksel tedavisi konservatiftir. Konservatif tedavi göğüs drenajı, anne sütünün kesilmesi, orta zincirli trigliserid içeren formula veya total parenteral nutrisyon uygulanmasıdır. Son yıllarda şilotoraks tedavisinde uzun etkili somatostatin analoğu olan ve lenfatik sıvı üretimini azaltarak etki gösteren oktreotid, yeni tedavi seçeneği olarak kullanılmaktadır. Prenatal ultrasonografide sağ akciğerde plevral efüzyon saptanan term bebekte, doğum sonrası konjenital şilotoraks tanısı kesinleştirildi. Öncelikle göğüs tüpü uygulandı, daha sonra orta zincirli trigliseridden zengin formula başlandı. Şilöz sıvı birikimi azalmayan olguya subkutanöz oktreotid tedavisi uygulandı ve yan etki görülmeden şilotoraks tedavi edildi. İnatçı şilotoraks olgularında cerrahi uygulamaya alternatif, umut verici bir tedavi seçeneği olan oktreotid, yenidoğan bebeklerde güvenle kullanılabilmektedir

Anahtar Kelimeler

Konjenital şilotoraks, oktreotid

A Case of Congenital Chylothorax Treated with Octreotide

Öz

Congenital chylothorax, an abnormal accumulation of chylous fluid in the pleural space, is a common cause of pleural effusion in the neonatal period. The traditional management of chylothorax is conservative. Conservative therapy includes chest drainage, cessation of breast feeding, and using of medium chain triglycerides or total parenteral nutrition. Recently, octreotide, a long-acting somatostatin analog reduced lymphatic fluid production, has been used as a new treatment strategy in the therapy of chylothorax. In a full term newborn with right pleural effusion diagnosed by prenatal ultrasound, congenital chylothorax is confirmed after birth. This patient was initially treated with chest tube insertion. Afterward a mediumchain-triglyceride-enriched formula was initiated. Subcutaneous octreotide was administered to the patient because of non-responded to conservative therapy. The chylothorax resolved promptly with no observed side effects. Octreotide appears to have a good safety drug in newborn infants and remains a promising alternative therapy to surgery for intractable cases with chylothoraces

Anahtar Kelimeler

Congenital chylothorax, octreotide

Kaynakça

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