Isolated chylous ascites in preterm infants:a case report and literature review
10.3760/cma.j.cn114798-20220128-00064
- VernacularTitle:早产儿乳糜腹5例分析及文献复习
- Author:
Meiying QUAN
1
;
Weilin WAN
;
Yu ZHANG
;
Lejia ZHANG
;
Chen WANG
;
Zhenghong LI
Author Information
1. 中国医学科学院 北京协和医院儿科，北京 100730
- Keywords:
Chylous ascites;
Prenatal diagnosis;
Infants, premature;
Nutrition therapy;
Octreotide;
Surgical therapy
- From:
Chinese Journal of General Practitioners
2022;21(10):972-975
- CountryChina
- Language:Chinese
-
Abstract:
The clinical data of 5 cases of chylous ascites in preterm infants admitted in NICU of Peking Union Hospital from 2001 to 2021 were retrospectively analyzed. There were 3 boys and 2 girls with the gestational age of 29 +1 weeks, and birth weight of (1 122±323) g. No peritoneal effusion was found on prenatal ultrasound examination. All the five cases diagnosed with chylous ascites after the initiation of enteral nutrition on d4 to d10. All cases were resolved by conservative treatment, including fasting with total parenteral nutrition for 3 wks. The parenteral nutrition strategy was specified by high protein concentration (4 g·kg -1·d -1) and low lipid emulsion (2.0-2.5 g·kg -1·d -1). Formula containing 50% medium chain triglyceride or human milk was fed sequentially, and no feeding intolerance or abdominal distension were observed. All patients were discharged stable and followed up for 3-5 years,and no recurrence occurred. The PubMed and Wanfang database were searched for cases of chylous ascites in preterm infants, and 7 cases were reported in literature. Six cases were diagnosed by antenatal ultrasound between 21 and 23 weeks of gestational age. Three cases underwent radionuclide lymphoscintigraphy, and 2 of them demonstrated peritoneal lymphatic fistula or lymphatic dilatation. Five cases were treated with fasting plus intravenous infusion of octreotide. Three infants who failed to respond to conservative treatment underwent surgical treatment. Four cases were complicated with sepsis and needed intravenous antibiotic treatment.
