Therapeutic management of neonatal chylous ascites: report of a case and review of the literature

Abstract

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.

Coexistence of Congenital Chylous Ascites and Congenital Hypothyroidism: Case Report

“…The physical appearance and biochemical content of ascites can change according to diet, nature of the lymphatic loss and cell content. 2,[8][9][10] In this study, we discussed the companionship of congenital hypothyroidism and CA in a newborn and its successful treatment with diet, medium-chain triglycerides (MCT) and octreotide in the light of the literature.…”

“…7 The majority of pediatric CA cases (45-70%) are congenital or idiopathic lymphatic abnormalities. 1,2,8,9 Besides, intussusception, intestinal malrotation, incarcerated hernia, obstructive lesions, traumas, peritoneal dialysis, liver cirrhosis, malignancy, surgical injuries, tuberculosis and other inflammatory peritoneal infections may be considered. 1,2,[8][9][10][11][12] The definitive diagnosis of CA depends on paracentesis.…”

“…1,2,8,9 Besides, intussusception, intestinal malrotation, incarcerated hernia, obstructive lesions, traumas, peritoneal dialysis, liver cirrhosis, malignancy, surgical injuries, tuberculosis and other inflammatory peritoneal infections may be considered. 1,2,[8][9][10][11][12] The definitive diagnosis of CA depends on paracentesis. 2,8 The most important feature of the fluid drawn by paracentesis is that it is rich in lymphocytes, protein and chylomicrons.…”

“…1,2,[8][9][10][11][12] The definitive diagnosis of CA depends on paracentesis. 2,8 The most important feature of the fluid drawn by paracentesis is that it is rich in lymphocytes, protein and chylomicrons. The physical appearance and biochemical content of ascites can change according to diet, nature of the lymphatic loss and cell content.…”

“…The most common cause of CA diagnosed in newborns is congenital malformation of lymphatic ducts. 1,2 The efficiency of octreotide together with diet has been proven in CA treatment. [1][2][3] Diagnosis of congenital hypothyroidism is generally made with newborn screenings.…”