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Case Reports
. 2012 Sep 25:2012:bcr2012006196.
doi: 10.1136/bcr-2012-006196.

Successful management of congenital chylous ascites with early octreotide and total parenteral nutrition in a newborn

Claudio Olivieri  1 , Lorenzo Nanni, Lucia Masini, Claudio Pintus
Affiliations
Case Reports

Successful management of congenital chylous ascites with early octreotide and total parenteral nutrition in a newborn

Claudio Olivieri et al. BMJ Case Rep. .

Abstract

Congenital chylous ascites (CCA) is a rare disease that results from maldevelopment of the intra-abdominal lymphatic system. Few cases have been described and no gold standard treatment has been defined so far. Octreotide, a somatostatin analogue, has been used for the treatment of CCA, but always after a failed conservative approach with fasting, total parenteral nutrition (TPN) or medium chain triglyceride (MCT) feeds. We report the case of a newborn with CCA treated by fasting, TPN and octreotide for a period of 15 days until the abdominal distension was successfully reduced at which point treatment was switched to an MCT formula. On day 25 the patient was breastfed and was discharged on day 33. No recurrence of chylous ascites was noted. Our experience highlights the successful treatment with TPN and octreotide as the first step for the conservative approach of CCA in a newborn, reducing the length of treatment and hospitalisation.

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Figures

Figure 1
Figure 1
Ultrasound examination of the fetal abdomen at 36 weeks showing a massive fluid collection surrounding the liver.
Figure 2
Figure 2
Orthostatic abdominal x-ray performed at birth after the paracentesis.
Figure 3
Figure 3
Changes of abdominal girth during the treatment.
See this image and copyright information in PMC

References

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