A newborn with chylous ascites caused by intestinal malrotation associated with heterotaxia syndrome

Seltz, L. Barry; Kanani, Ronik; Zamakhshary, Mohammed; Chiu, Priscilla

doi:10.1007/s00383-008-2127-7

Cited by 9 publications

(5 citation statements)

References 7 publications

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“…Chylous ascites is a rare finding in infants usually arising from trauma, obstruction, or congenital lymphatic abnormalities [3]. A few cases of malrotation and chylous ascites are documented in the literature, and it is postulated that lymphatic obstruction from midgut volvulus leads to the leakage of chyle into the peritoneum [4]. Our case indicates that malrotation can be discovered incidentally during the workup of other illnesses.…”

mentioning

confidence: 80%

Incidental chylous fluid during hernia repair may be a harbinger of malrotation

Zarroug

Srinivasan

Wulkan

2010

Journal of Pediatric Surgery

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mentioning

confidence: 80%

Incidental chylous fluid during hernia repair may be a harbinger of malrotation

Zarroug

Srinivasan

Wulkan

2010

Journal of Pediatric Surgery

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“…The intestinal condition was classified according to whether a bowel ischemic change was present or absent and whether bowel resection was necessary. In patients who had intestinal volvulus with 0° of twist intraoperatively, the diagnosis of intestinal volvulus was made on the basis of chylous ascites, lymphatic congestion of the mesentery, and the presence of underlying diseases such as intestinal malrotation …”

Section: Methodsmentioning

confidence: 99%

“…In patients who had intestinal volvulus with 0 of twist intraoperatively, the diagnosis of intestinal volvulus was made on the basis of chylous ascites, lymphatic congestion of the mesentery, and the presence of underlying diseases such as intestinal malrotation. 20,21 A bowel ischemic change was identified on the basis of the exploratory laparotomy findings A, Grayscale transverse sonogram through the mid upper abdomen shows a twist in the intestine (curved arrow). The intestinal twist is 180 .…”

Section: Diagnosis Of Intestinal Volvulus and Definitions Of Bowel Ismentioning

confidence: 99%

Use of ultrasound findings to predict bowel ischemic changes in pediatric patients with intestinal volvulus

Hosokawa

Tanami

et al. 2019

J of Ultrasound Medicine

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Objectives Early diagnosis and prompt surgical intervention are important to prevent intestinal necrosis in patients with volvulus. The purpose of this study was to determine which ultrasound (US) findings may predict bowel ischemic changes in pediatric patients with intestinal volvulus. Methods Thirty‐one pediatric patients with surgically proven intestinal volvulus were retrospectively reviewed. We compared the demographics and US findings (eg, superior mesenteric artery collapse, ascites, echogenic ascites, and degree of intestinal twist) between patients with and without bowel ischemic changes during surgery. Data are presented as median and range. The Fisher exact test, Mann‐Whitney U test, and Wilcoxon signed rank sum test were used for statistical analyses. Results Eleven patients had bowel ischemic changes. Significant differences existed between patients with and without ischemic changes for age (2 days [range, 0–137 days] versus 6.5 days [range, 2–1618 days]; P = .02), superior mesenteric artery collapse (present/absent, 10/1 versus 9/11 patients; P = .02), the presence of ascites (present/absent, 8/3 versus 6/14 patients; P = .03), and intestinal twist degree on US imaging (540° [range, 180°–720°] versus 360° [range, 180°–720°]; P = .02). The groups did not significantly differ for sex, the time from the US examination to the operation, or echogenic ascites. The intestinal twist degree insignificantly differed between US and surgical findings (360° [range, 180°–720°] versus 360° [range, 0°–1080°]; P = .36). Conclusions The presence of superior mesenteric artery collapse, ascites, and a large intestinal twist on US imaging were significant predictors of intestinal ischemic changes. Pediatric surgeons should perform prompt surgical interventions in cases of volvulus with these US findings.

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“…15,16 A case of portal cavernous transformation with various congenital abnormalities without polysplenia (and two cases of PS presented with ascites, the etiologies were intrauterine heart failure due to cardiac abnormalities and chylous ascites caused by intestinal malrotation) have been reported. [16][17][18] However, there are no cases of PS that present with ascites due to prehepatic portal hypertension caused by portal cavernous transformations in the literature.…”

Section: Fi Gu Re 1cmentioning

confidence: 99%

A Case of Polysplenia Syndrome Presenting with Ascites

Fidan¹,

Erkut²,

Demirel³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T Polysplenia syndrome is a rare congenital anomaly frequently associated with various visceral anomalies. The most frequent manifestations of this syndrome, in addition to polysplenia are malrotation, congenital heart diseases and gastrointestinal, genitourinary and vascular abnormalities. In this report, we present an adult case of ascites due to prehepatic portal hypertension associated with portal cavernous transformation. The patient had a left-sided liver, right-sided multiple splenules and stomach, interrupted inferior vena cava with azygos continuation and extensive ascites. The portal vein was not observed and collateral vascular structures of cavernous transformation were identified in the hepatic hilus. Portal cavernous transformation with various congenital abnormalities has been reported in the literature; however, there are no cases of polysplenia syndrome presenting with ascites associated with portal cavernous transformation.K Ke ey y W Wo or rd ds s: : Ascites; situs inversus; spleen Ö ÖZ ZE ET T Polispleni sendromu sıklıkla çeşitli organ anomalileri ile ilişkili nadir bir konjenital anomalidir. Polispleniye ek olarak bu sendromun en sık görülen belirtileri malrotasyon, konjenital kalp hastalıkları, genitoüriner, gastrointestinal ve vasküler anomalilerdir. Bu yazıda, portal kavernöz transformasyon ile ilişkili prehepatik portal hipertansiyona bağlı asit gelişmiş olan erişkin bir olgu sunulmuştur. Hastada sol taraflı karaciğer, sağ taraflı çok sayıda aksesuar dalak ve mide, azygos devamlılığı ile kesintiye uğramış inferior vena kava ve yaygın asit vardı. Portal ven gözlenmedi ve karaciğer hilusunda kavernöz transformasyonlu kollateral vasküler yapılar tespit edildi. Literatürde portal kavernöz transformasyon ile beraber çeşitli konjenital anomaliler mevcuttur, ancak asit ile gelen portal kavernöz transformasyon ile ilişkili polispleni sendromu olgusu henüz bildirilmemiştir.A An na ah ht ta ar r K Ke el li im me el le er r: : Asit; situs inversus; dalak T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J M Me ed d S Sc ci i 2 20 01 12 2; ;3 32 2(

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A newborn with chylous ascites caused by intestinal malrotation associated with heterotaxia syndrome

Cited by 9 publications

References 7 publications

Incidental chylous fluid during hernia repair may be a harbinger of malrotation

Incidental chylous fluid during hernia repair may be a harbinger of malrotation

Use of ultrasound findings to predict bowel ischemic changes in pediatric patients with intestinal volvulus

A Case of Polysplenia Syndrome Presenting with Ascites

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