Postoperative Chylous Ascites in a Neonate Treated Successfully with Octreotide: Bile Sludge and Cholestasis

Andreou, Alexander; Papouli, Maria; Papavasiliou, Vaso; Badouraki, Maria

doi:10.1055/s-2005-872588

Cited by 18 publications

(15 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although we did not find any of the more commonly reported side effects like severe gastrointestinal problems (for example, necrotizing enterocolitis) [19] , hypothyroidism, cholelithiasis [20,21] and retinal problems [22,23] , we did find a relatively high occurrence of PPHN which required treatment.…”

Section: Discussionmentioning

confidence: 54%

Is Octreotide Treatment Useful in Patients with Congenital Chylothorax?

2011

View full text Add to dashboard Cite

Background: Congenital chylothorax (CC) is a severe congenital disorder characterized by the collection of chyle in the pleural space. Recent case reports suggest that the use of octreotide in the treatment of CC may be useful. Objective: To evaluate the effect of octreotide on pleural effusions in CC. Methods: Hospital records of 7 patients with a CC, who were admitted to the Neonatal Intensive Care Unit of the Radboud University Nijmegen Medical Centre between 2006 and 2010 and were treated with octreotide, were retrospectively evaluated. Results: There was no clear and consistent effect of octreotide treatment on pleural effusions. Pleural effusions eventually decreased in all patients after reaching a dose of 5–6 µg/kg/min, but this could also reflect the natural history of CC. Out of 7 patients, 4 were diagnosed with persistent pulmonary hypertension of the newborn. No other known side effects of octreotide were found. There was a mortality rate of 30%. Conclusions: No clear and consistent effect of octreotide was identified. Pulmonary hypertension was a common problem in this patient group. It is not clear whether or not this was caused or maintained by octreotide treatment. A randomized controlled trial is needed to investigate the safety and usefulness of octreotide. Until then, clinicians should be careful in using octreotide, especially when persistent pulmonary hypertension is present.

show abstract

Section: Discussionmentioning

confidence: 54%

Is Octreotide Treatment Useful in Patients with Congenital Chylothorax?

2011

View full text Add to dashboard Cite

show abstract

“…We preferred the latter route since the baby was in the intensive care unit (ICU) and had a convenient line. However, OCT dosing has not been established in neonates, and the risk of long-term consequences remains unknown [7], while the peritoneal equilibrium test after OCT has shown no short-term effect on peritoneal function in an adult patient [3]. Our choice of dosage and duration was based on published reports on pediatric patients treated with OCT [7,12].…”

Section: Discussionmentioning

confidence: 99%

“…When conservative methods fail, surgery is recommended [7]. Octreotide (OCT) has recently been used safely in the treatment of CP, even in neonates [3,7]. Here, we present a preterm baby with CP who partially benefited from an MCT-based diet and OCT and who totally recovered after the discontinuation of PD for 2 days.…”

Section: Introductionmentioning

confidence: 92%

“…Conservative treatment for CP consists of providing total parenteral nutrition or enteral nutrition based on medium-chain triglycerides (MCTs) with or without lymph drainage [7]. When conservative methods fail, surgery is recommended [7]. Octreotide (OCT) has recently been used safely in the treatment of CP, even in neonates [3,7].…”

Section: Introductionmentioning

confidence: 99%

“…However, as a problem complicating peritoneal dialysis (PD), CP is mostly seen in adults and very rarely in children and neonates [2][3][4][5][6]. Conservative treatment for CP consists of providing total parenteral nutrition or enteral nutrition based on medium-chain triglycerides (MCTs) with or without lymph drainage [7]. When conservative methods fail, surgery is recommended [7].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Resolution of chyloperitoneum in a preterm with octreotide, diet and cessation of dialysis

et al. 2010

View full text Add to dashboard Cite

The diagnosis of chyloperitoneum (CP) is based on the presence of high levels of triglycerides (TGs) in the dialysate. It is a rare complication of peritoneal dialysis (PD) and even rarer in neonates. We report here the case of CP in a 1700-g male baby delivered at the 30th gestational week due to posterior urethral valve and associated oligohydramnios. On postnatal day 2, the serum creatinine (Scr) was 1.6 mg/dL, and he was anuric. PD was instituted via a Tenckhoff catheter. At the end of the second week, after the initiation of enteral feeding, the ultrafiltrate became cloudy, with a leukocyte count of 900/mm(3). A treatment regimen consisting of intraperitoneal vancomycin and ceftazidime was then started. Five days later, the fluid became milky, with a TG level of 251 mg/dL. The patient was then placed on a diet based on medium-chain triglycerides and octreotide (1 microg/kg/h; increasing up to 2 microg/kg/h over 15 days). Although the TG and leukocyte levels decreased, the milky appearance persisted. PD was stopped for 2 days when the Scr decreased to 1.7 mg/dL. When it was resumed, the fluid was totally clear, with a TG level of 7 mg/dL. The infant was discharged with a nightly intermittent peritoneal dialysis program and has had no recurrence. In summary, we report a preterm infant who developed CP during PD and recovered following treatment that included diet modification, octreotide, and temporary discontinuation of the PD.

show abstract