SUCCESSFUL SURGICAL TREATMENT OF A NEWBORN WITH CHYLOPERITONEUM

Cover Page


Cite item

Full Text

Abstract

The article describes clinical observation of treatment of a premature infant with chyloperitoneum. Accumulation of fluid in the abdominal cavity was diagnosed prenatally at 31–32 weeks of gestation. Premature surgical delivery was performed at 34– 35 weeks due to the high risk of antenatal fetal death. Paracentesis with fluid analysis was done; chylous exudate was confirmed. Total parenteral nutrition, octreotide and drainage of the abdominal cavity were used during conservative treatment. It was decided to perform a surgery as the therapy was ineffective. At the age of 2 months and 7 days laparotomy was conducted, abdominal organs were revised, lymph ducts were ligated, and abdominal cavity was drained producing a positive effect. The fluid outflow was terminated and the child was discharged in a satisfactory condition.

About the authors

Yu. I. Kucherov

G. N. Speransky City Children’s Hospital № 9, Moscow;
Pirogov Russian National Research Medical University (RNRMU), Moscow

Author for correspondence.
Email: ykucherov@mail.ru

Dr. Sci(Med), Professor of the Department of Pediatric Surgery of the Pirogov Russian National Research Medical University (RNRMU);

Head of the Department of Emergency Surgery of the G. N. Speransky City Children’s Hospital № 9

Россия

N. V. Kholodnova

G. N. Speransky City Children’s Hospital № 9, Moscow

Email: kholodnova.natalia@gmail.com
Neonatologist of the 8th Infectious Diseases Department for Newborn G. N. Speransky City Children’s Hospital № 9 Россия

S. R. Adleiba

G. N. Speransky City Children’s Hospital № 9, Moscow;
Pirogov Russian National Research Medical University (RNRMU), Moscow

Email: saidanczd@mail.ru

Junior Researcher, Department of Pediatric Surgery of the Pirogov Russian National Research Medical University (RNRMU);

5th pediatric surgical department of the G. N. Speransky City Children’s Hospital № 9

Россия

A. L. Belaya

G. N. Speransky City Children’s Hospital № 9, Moscow

Email: annabelaia.dgkb9@mail.ru
Neonatologist of the 8th Infectious Diseases Department for Newborn G. N. Speransky City Children’s Hospital № 9 Россия

L. M. Makarova

G. N. Speransky City Children’s Hospital № 9, Moscow

Email: makarova.inf8@yandex.ru
Neonatologist of the highest category, head of the 8th Infectious Diseases Department for Newborns of G. N. Speransky City Children’s Hospital № 9 Россия

M. A. Ovsiannikova

G. N. Speransky City Children’s Hospital № 9, Moscow

Email: marinaovs86@mail.ru
Neonatologist of the 8th Infectious Diseases Department for Newborn G. N. Speransky City Children’s Hospital № 9 Россия

Yu. V. Zhirkova

G. N. Speransky City Children’s Hospital № 9, Moscow;
Pirogov Russian National Research Medical University (RNRMU), Moscow

Email: zhirkova@mail.ru

Dr. Sci(Med), professor, head of the educational department of the Department of Pediatric Anesthesiology and Intensive Therapy of the Pirogov Russian National Research Medical University (RNRMU);

anesthesiologist G. N. Speransky City Children’s Hospital № 9

Россия

References

  1. Cochran W. J., Klish W. J., Brown M. R., Lyons J. M., Curtis T. Chylous ascites in infants and children: a case report and literature review. J. Pediatr. Gastroenterol Nutr.1985;4:668–73.
  2. Bellini C. and Hennekam C. M. Non-immune hydrops fetalis: A short review of etiology and pathophysiology. Am J. Med. Genet.Part A. 2012;158А:597–605.
  3. Herman T. E., Siegel M. J. Imaging Case Report. Congenital Chylous Ascites. Journal of Perinatology. 2009;29:178–80.
  4. Qi H., Bu-jun G., Li-ming L., Zhi-yuan T., Guo-fen Z., Yue-zu F. Successful management of chylous ascites with total parenteral nutrition, somatostatin and fibrin glue. Chin Med J. 2007;120:1847–9.
  5. Gaty M. G., Hilfiker M. L., Azizkhan R. G., Glick P. L. Successful treatment of congenital chylous ascites with a somatostatin analogue. Pediatr. Surg. Int. 1996;11:396–7.
  6. Petropoulos A. S., Sfougaris D. K., Mouravas V. K. Birth defects of the lymphatic system. In: Gaslem N. A., editor. New developments in birth defects research. New York. Nova Science Publishers, Inc. 2007:1–67.
  7. Kuroiwa M., Toki F., Suzuki M., Suzuki N. Successful laparoscopic ligation of the lymphatic trunk for refractory chylous ascites. J. Pediatr. Surg. 2007;42:E15–18. http://dx.doi.org/10.1016/j.jpedsurg.2007.02.036.
  8. Alliet P., Young C., Lebenthal E. Chylous ascites: total parenteral nutrition as primary therapeutic modality. Eur J Pediatr. 1992;151:213–4.
  9. Chye J. K., Lim C. T., Van der Heuvel M. Neonatal chylous ascites-report of three cases and review of the literature. Pediatr. Surg. Int. 1997;12:296–8.
  10. Huang Y., Xu H. Successful Treatment of Neonatal Idiopathic Chylous Ascites with Total Parenteral Nutrition and Somatostatin. HK J. Paediatr. (new series). 2008;13:130–4.
  11. Karagol B. S., Zenciroglu A., Gokce S., Kundak A. A., Ipek M. S. Therapeutic management of neonatal chylous ascites: Report of a case and review of the literature. Acta Paediatr. 2010; 99:1307–10 doi: 10.1111/j.1651–2227.2010.01818.
  12. Bellini C., Hennekam R. C., Fulcheri E., Rutigliani M., Morcaldi G., Boccardo F. Etiology of nonimmune hydrops fetalis: A systematic review. Am. J. Med.Genet. 2009;149A:844–51. doi: 10.1002/ajmg.a.32655.
  13. Bellini C., Hennekam R. C. Non-immune hydrops fetalis: A short review of etiology and pathophysiology. Am. J. Med. Genet. 2012;158A: 597–605. https://doi.org/10.1002/ajmg.a.34438.
  14. Садовникова И. В., Широкова Н. Ю., Тихомиров Г. В. Врожденный хилезный асцит. Клинический случай. Экспериментальная и клиническая гастроэнтерология. 2015;113(1):84–7.
  15. Said A. Al-Busafi, Peter Ghali, Marc Deschênes, and Philip Wong. Review Article Chylous Ascites: Evaluation and Management. Hindawi Publishing Corporation ISRN Hepatology Volume 2014, Article ID240473, 10 pages. http:// dx.doi.org/10.1155/2014/240473.
  16. Drinnen D., Filston H. C. An unusual case of Gastroschisis with gallbladder evisceration and late postrepair chylous Ascites. J. Pediatr Surg. 1997;32:1804–5.
  17. Lloyd D. A. Gastroschisis, malrotation and chylous ascites. J. Pediatr. Surg. 1994;26:106–7.
  18. Beshay V., Beshay J., Rosenberg A. Chylous ascites: a case of child abuse and an overview of a rare condition. J. Pediatr. Gastroenterol Nutr, 2001;32:487–9.
  19. Romanska-Kita J., Borszewska-Kornacka M.K., Dobrzanska A., Rudzinska I., Czech-Kowalska J., Wawrzoniak T. Congenital chylous ascites. Pol. J. Radiol. 2011;76:58–61.
  20. Bhatia C., Pratap U., Slavik Z. Octreotide therapy: a new horizon in treatment of iatrogenic chyloperitoneum. Arch Dis Child, 2001;85:234–35. http://dx.doi.org/10.1136/adc.85.3.234.
  21. Mitsunaga T., Yoshida H., Iwai J., Matsunaga T., Kouchi K., Ohtsuka Y., Okada T., Hishiki T., Ohnuma N. Successful surgical treatment of two cases of congenital chylous ascites. J. Pediatr. Surg, 2001;36:1717–19. https://doi.org/10.1007/ s12098–010–0193-z.
  22. Unger S. W., Chandler J. G. Chylous ascites in infants and children. Surgery, 1983;93:455–61.
  23. Antalo B., Croaker D., Squire R. Successful management of congenital chyloperitoneum with fibrin glue. J. Pediatr. Surg. 2003;38:E7–E8.
  24. Rasha Kassem, Abdullah Rajab, Ahamed Faiz, Sunil Yadav Kumar, Sam Aruputha John, Ola Taher. Chylous ascites in an infant – Treated surgically with fibrin glue after failed medical treatment – A case report. Journal of Pediatric Surgery Case Reports 2017;19:25–7. doi: 10.1016/j.epsc.2017.02.002.
  25. Zeidan S., Delarue A., Rome A., Roguelaure B. Fibrin glue application in the management of refractory chylous ascites in children. J. Pediatr. Gastroenetrol Nutr, 2008;46:478–81.
  26. Fishman S. J., Burrows P. E., Upton J., Hendren W. H. Life-threatening anomalies of the thoracic duct: anatomic delineation dictates management. J. Pediatr. Surg. 2001;36:1269–72.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2019 Kucherov Y.I., Kholodnova N.V., Adleiba S.R., Belaya A.L., Makarova L.M., Ovsiannikova M.A., Zhirkova Y.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: ПИ № ФС 77 - 81892 от 24.09.2021 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies