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 de!ned as the accumulation of chyle into the peritoneal cavity in infants younger than 3 months. is condition is o"en refractory to therapy and it is responsible for serious malnutrition and immunological de!ciency because of the loss of proteins and lymphocytes. Material and methods: Four cases of congenital neonatal chylous ascites, were treated by our sta# 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 le" lumbar lymphatic trunk and cisterna chyli and the use of !brin 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 di$cult 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. Hippokratia 2012; 16 (2): 175-180