Chylothorax associated with a PICC line in a very low birth weight infant

A premature female neonate with perforated necrotizing enterocolitis (NEC) required a laparotomy as well as a prolonged period of parental nutrition (PN) delivered via a left percutaneously inserted central catheter (PICC). Two weeks post PICC insertion, she developed left chylothorax with positioning of the PICC tip at the inlet of the thoracic duct. We concluded that the chylothorax was secondary to occlusion of the thoracic inlet to the venous system by the tip of the central line and PN.