Bochdalek hernia 根治術後の乳糜胸の1治験例

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To authors' knowlege, only two cases developing chylothorax following herniorrhaphy have been reported in the literature. This report discribes the third case of this unusual complication with Bochdalek hernia repair, and discusses the cause and method of treatment. A male infant weighing 3.55 kilograms, was born on July 17 1978, following normal pregnancy, labor and delivery. The patient's development was normal until two months of age. Vomiting first noted on October 3 1978 became to be seen after every oral feeding. The patient was transferred to our hospital. A chest x-ray film showed typical findings of left Bochdalek hernia, but no respiratory distress was noted. Through an abdominal approach, the left posterolateral diaphragmatic hernia with a thin sac was closed by mattress sutures with the sac removed. The immediate postoperative period was complicated with left pneumothorax treated by a chest tube insertion and continuous suction. On the second postoperative day, after oral feeding was started, drainage from the chest tube increased. Next day, the fluid became milky. Chylous fluid volume was small, but it did not decrease. Premilk started on the 7th day was changed to a medium-chain triglyceride milk, on the twelfth postoperative day, which seemed effective to stop drainage of chyle. The chest tube was removed 22 days after operation. The patient was discharged on the 36th hostital day in good condition. At present, he is one year old with normal growth and development.
日本小児外科学会の論文
1980-10-20

Bochdalek hernia 根治術後の乳糜胸の1治験例

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