CONGENITAL CHYLOUS ASCITES IN INFANT. A CASE REPORT AND REVIEW
Tinuk Agung Meilany Budi Purnomo
Nutrition and Metabolic Disease Division, Gastroenterology Division, Harapan Kita Children and Woman Hospital, Jakarta Indonesia
Congenital chylous ascites (CCA) is a rare disease that results from mal development of the intra-abdominal lymphatic system and no gold standard treatment described so far. It is defined as an accumulation of triglyceride-rich milky fluid into peritoneal cavity in infant younger than three months.
Medium chain triglyceride (MCT)-based diet or total parental nutrition (TPN) with rest to bowel and abdominal paracentesis is the time honoured conservative management. Due to rare incidence of this disorder, the existing literature includes mainly case reports where TPN was used with or without MCT based formulas along with octreotide. This condition is often refractory to therapy and is responsible for serious malnutrition and immunological deficiency because of loss of proteins and lymphocytes.
Its treatment is often frustrating and challenge to physician. We report an infant with chylousascites which was refractory to medical treatment in the form of prolonged bowel rest with TPN, Octreotide and repeated paracentesis. Whether a surgical treatment in the lymphatic leak area should be performed for healing the patient in the next step ?
Keywords: Chylous ascites infant nutritional status
Disclaimer: The Views and opinions expressed in the articles are of the authors and not of the journal.
Mid City Hospital, 3-A Shadman II
Jail Road, Lahore ,Pakistan