title: Successful management of congenital chylous ascites with early octreotide and total parenteral nutrition in a newborn.
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.
authors.affiliation: Pediatric Surgery Unit, Policlinico A. Gemelli, Rome, Italy. claudioolivieri@libero.it
authors.forename: Claudio
authors.initials: C
authors.lastname: Olivieri
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Nanni
authors.forename: Lucia
authors.initials: L
authors.lastname: Masini
authors.forename: Claudio
authors.initials: C
authors.lastname: Pintus
mesh_terms: D002915:Chylous Ascites / Q000151:congenital* / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D015282:Octreotide / Q000627:therapeutic use*; D010289:Parenteral Nutrition, Total / Q000379:methods
chemical_list: D005765:Gastrointestinal Agents; D015282:Octreotide