Therapeutic Management of Neonatal Chylous Ascites: Report of a Case and Review of the Literature

Acta Paediatr. 2010 Sep;99(9):1307-10. doi: 10.1111/j.1651-2227.2010.01818.x.

Abstract

Congenital chylous ascites is a rare condition seen in the neonatal period and the data on pathogenesis and treatment modalities are limited. In this article, we report a case of neonate with chylous ascites and review the therapeutic management procedures on chylous ascites in childhood. We present our experience in the diagnosis and treatment of this condition.

Conclusion: Medium-chain triglycerides (MCT)-based diet can be tried as a first option in chylous ascites treatment. In resistant or unresponsive cases, somatostatin along with TPN can have use in closing the lymphatic leakage or relieving the symptoms effectively and rapidly. Conventional regimens including enteral feeding with MCT-based formula can then be re-administered as a maintenance treatment after reduction of lymph flow with the use of total parenteral nutrition (TPN) and somatostatin infusion combination. Patient-specific approach should be attempted for chylous ascites caused by various disorders and started as soon as possible.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Chylous Ascites / congenital*
  • Chylous Ascites / diagnosis
  • Chylous Ascites / therapy*
  • Diet, Fat-Restricted
  • Enteral Nutrition / methods*
  • Gastrointestinal Agents / administration & dosage
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Infant Formula
  • Infant, Newborn
  • Male
  • Octreotide / administration & dosage
  • Octreotide / therapeutic use*
  • Parenteral Nutrition, Total
  • Somatostatin / administration & dosage
  • Somatostatin / analogs & derivatives
  • Somatostatin / therapeutic use
  • Triglycerides / administration & dosage
  • Triglycerides / therapeutic use*

Substances

  • Gastrointestinal Agents
  • Triglycerides
  • Somatostatin
  • Octreotide