Successful surgical treatment of two cases of congenital chylous ascites

Voluminous Fetal Chylous Ascites: A Case of Complete Spontaneous Prenatal Regression

“…Three articles specified that labor was induced. One infant was delivered by cesarean at 34 weeks [7] . Mean term at delivery was 36-37 weeks, with most newborns healthy and of normal size, with transient respiratory distress in some cases, due to the abdominal volume.…”

“…Spontaneous disappearance without any treatment was noted in less than 2 weeks in two of the newborns [6] . In the remaining two cases, persistence of the ascites made surgery necessary, despite appropriate medical treatment that included a diet excluding first long-chain triglycerides and then enteral nutrition [7] . 99-Technetium albumin scintigraphy revealed lymphatic fluid diffusion into the peritoneal cavity from the right suprarenal region.…”

Chylous Ascites in a Newborn with Gastroschisis. Case Report

“…There are two management schemes: fasting and the use of MCT rich formulas to decrease lymph production in the intestine, facilitating closure of the fistula. The success with this treatment has been reported as 63.9% in a series of 103 patients in Japan [5]. Use of octreotide, an analog of somatostatin, has also been reported to decrease lymph production.…”

“…The time to define whether there is lack of response to medical treatment has not yet been determined. Different articles report a range between 1 and 2 months [5,7,8]. It is important during this period to assure that the patient has good nutrition and rule out hypogammaglobulinemia, two factors associated with infections that could compromise the life of the patient.…”

Refractory Congenital Chylous Ascites

“…Cases of refractory CCA in neonates are scarce in the literature and no gold standard treatment has been defined so far [3,4].…”