Description:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Importance</jats:title><jats:p>Chylothorax is the most common cause of pleural effusion in neonates and relatively rare in children. It can cause significant respiratory morbidity. Many clinical entities may contribute to chylothorax.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To investigate the causes and manifestations of chylothorax in infants and children in China.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Case records of 107 cases with chylothorax seen in Beijing Children's Hospital from 2007 to 2017 were retrieved and analyzed; follow‐up was carried out by telephone.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of 107 cases, 58.9% (63/107) were primary chylothorax (<jats:styled-content style="fixed-case">PC</jats:styled-content>) and 41.1% (44/107) were secondary chylothorax (<jats:styled-content style="fixed-case">SC</jats:styled-content>). Also, 36.4% (39/107) were neonatal chylothorax (<jats:styled-content style="fixed-case">NC</jats:styled-content>) and 35.5% (38/107) were postoperative chylothorax. In <jats:styled-content style="fixed-case">PC</jats:styled-content> with a verified lymphatic anomaly, there was one case of diffuse pulmonary lymphangiomatosis (<jats:styled-content style="fixed-case">DPL</jats:styled-content>) and six cases of generalized lymphatic anomaly (<jats:styled-content style="fixed-case">GLA</jats:styled-content>), which accounted for 6.5% (7/107) of cases. In most patients, chylothorax was alleviated by conservative treatment based on total parenteral nutrition (<jats:styled-content style="fixed-case">TPN</jats:styled-content>); 13.1% (14/107) of cases needed further surgery. In <jats:styled-content style="fixed-case">NC</jats:styled-content>, the median duration of <jats:styled-content style="fixed-case">TPN</jats:styled-content> was 9 days, but 10 of 20 cases who improved had recurrence upon re‐introduction of a fat‐free diet, which was alleviated by further <jats:styled-content style="fixed-case">TPN</jats:styled-content>. The duration of hospitalization was (23 ± 14) days for congenital chylothorax. Upon long‐ term follow‐up, except for <jats:styled-content style="fixed-case">GLA</jats:styled-content> and <jats:styled-content style="fixed-case">DPL</jats:styled-content>, most patients were doing well without recurrence.</jats:p></jats:sec><jats:sec><jats:title>Interpretation</jats:title><jats:p><jats:styled-content style="fixed-case">NC</jats:styled-content> and postoperative chylothorax are the common subtypes. <jats:styled-content style="fixed-case">TPN</jats:styled-content> is effective for most patients. Despite a prolonged and fluctuating clinical course, most patients had a good long‐term prognosis.</jats:p></jats:sec>