Chylothorax Secondary to Late-Onset Congenital Diaphragmatic Hernia

Congenital diaphragmatic hernia (CDH) is a structural diaphragmatic defect that usually presents during the first few hours after birth with severe respiratory distress. However, delayed herniation of the abdominal contents through a CDH may occur beyond neonatal period. In contrast to the high mortality and morbidity rates for neonatal CDH, the prognosis for late-presenting CDH is usually favorable if diagnosed earlier. However, unlike in neonates, the spectrum of manifestations of late-presenting CDH is quite broad and nonspecific. The patients may present with acute or chronic respiratory, gastrointestinal symptoms or be completely asymptomatic [1]. The variety of clinical manifestations for late-onset CDH makes the early diagnosis challenging. Chylothorax, the accumulation of chyle in the pleural space, is a relatively rare cause of pleural effusion in children after neonatal period [2]. Late-presenting CDH and chylothorax are rarely associated. We reported a 3-monthold infant of late-presenting CDH with development of chylous effusion.