Serum and chyle lipids during medium-chain triglyceride feeding in a child with chylothorax

Abstract

A 7-year-old boy with a traumatic chylothorax was treated with a medium-chain triglyceride (MCT) diet. Less than 1% of the ingested caprylic (C 8: 0) and between 2 and 3% of the capric acid (C 10: 0) appeared in the chyle triglycerides. Neither of these fatty acids was detected in the serum triglycerides. Fasting serum triglyceride concentrations were raised before MCT feeding, and decreased towards normal during MCT feeding. The fatty acid composition of the serum triglycerides suggested that the reduction was due to decreased lipogenesis from carbohydrate. Chyle flow during the period of MCT feeding did not diminish sufficiently to allow spontaneous closure of the tear in the thoracic duct, which was subsequently ligated.