Diagnosis and management of congenital neonatal chylous ascites.
BACKGROUND
Congenital chylous ascites is a rare condition that constitutes a challenge for the physician. It is defined as the accumulation of chyle into the peritoneal cavity in infants younger than 3 months. This condition is often refractory to therapy and it is responsible for serious malnutrition and immunological deficiency because of the loss of proteins and lymphocytes.


METHODS
Four cases of congenital neonatal chylous ascites, were treated by our staff during the last two years. One case was treated conservatively and three with laparotomy. Two of them had intraabdominal cysts that were excised and one was treated with ligation of the left lumbar lymphatic trunk and cisterna chyli and the use of fibrin glue.


RESULTS
All four cases were treated successfully. On follow up tests no one showed recurrence of the ascites. All children, except the one that treated conservatively and also had other problems due to prematurity, are growing up normally.


CONCLUSIONS
Congenital chylous ascites is a complex condition. Its diagnostic evaluation is difficult and its therapy of long duration. Conservative treatment is in most cases the initial choice, but when it fails, exploratory laparotomy could provide a successful alternative.
2 Department of Pediatric Surgery, Aristotle University of Thessaloniki, General Hospital "Papageorgiou", Thessaloniki, Greece.
V
V
Mouravas
O
O
Dede
H
H
Hatziioannidis
I
I
Spyridakis
A
A
Filippopoulos
chyloperitoneum; chylous ascites; cysterna chyli; intestinal duplication; mesenteric cyst; neonate