Chylothorax

A chylothorax is a pleural effusion composed of lymphatic fluid. In children, the most common etiology is iatrogenic following an operation within the posterior mediastinum. Procedures on the esophagus and thoracic aorta, such as ligation of a patent ductus arteriosus, coarctation repair, and Fontan procedure, are at highest risk for this complication. Ten percent of chylothoraces in the pediatric population are congenital. Other important causes of chylothoraces in children include superior vena cava obstruction, blunt and penetrating trauma, lymphatic malformations, malignancy, and following diaphragmatic hernia repair, particularly in the setting of right heart failure.