Successful Treatment of Intractable Chylothorax with Povidone-Iodine Pleurodesis in Extremely Preterm Infant

Chylothorax is pleural collection of fluid formed by the escape of chyle from the thoracic duct or lymphatics into the thoracic cavity. In children, it frequently occurs after thoracic duct injury as a complication of cardiothoracic surgery. It can be treated with enteral feedings with a low-fat or medium-chain triglyceride, high-protein diet, and total parenteral nutrition. Somatostatin and octreotide have been used in advanced cases and surgical treatment could be considered including a pleuroperitoneal shunt, thoracic duct ligation, and pleurodesis with sclerosing agent such as tetracyclin, bleomycin, OK-432, talc, or iodopovidone. We report a case of preterm infant with 24+4 weeks of gestation who developed chylothorax after ligation of patent ductus arteriosus. The chylothorax was intractable to any medical and conservative treatments but was treated successfully by pleurodesis with 3.4% povidone-iodine without complications.