Management and prognosis of congenital chylous ascites in 20 infants
10.3760/cma.j.cn113903-20220214-00124
- VernacularTitle:20例先天性乳糜腹患儿的处理及预后
- Author:
Jialiang ZHOU
1
;
Juan ZHU
;
Xiaochun ZHU
;
Rong HUANG
;
Yuanlong FANG
;
Qingyuan WANG
;
Wuping GE
Author Information
1. 广东省妇幼保健院新生儿外科，广州 511400
- Keywords:
Chylous ascites;
Conservative treatment;
Prognosis;
Infant, newborn
- From:
Chinese Journal of Perinatal Medicine
2022;25(8):615-619
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the perinatal management and prognosis of congenital chylous ascites (CCA).Methods:Clinical data of 20 infants diagnosed with CCA and treated in Guangdong Women and Children Hospital from June 2015 to November 2020 were retrospectively analyzed and described.Results:There were ten patients with isolated CCA and ten with non-isolated CCA. In isolated CCA cases, seven were cured after conservative treatment and three after postoperative conservative treatment following an ineffective surgery. Non-isolated CCA cases were complicated by intrauterine cytomegalovirus infection ( n=1), malrotation of intestine ( n=4) or bilateral chylothorax ( n=5). In addition to conservative treatment for CCA, non-isolated CCA patients also received antiviral therapy, Ladd's procedure or intrauterine/extrauterine closed thoracic drainage. Of eight patients who were firstly diagnosed with ascites before 30 gestational weeks, including four isolated and four non-isolated cases, only one underwent surgical intervention. During hospitalization, serious infections occurred in three infants with isolated CCA and two with non-isolated CCA, and were all controlled by anti-infection treatment. During a follow-up to median age of 29 months (15-82 months), none of the patients had any abnormalities except for the one with intrauterine cytomegalovirus infection who was deaf at the age of two. Conclusions:Conservative management is effective and the prognosis is generally good for most cases with isolated CCA. Treatment and prognosis of non-isolated CCA depend on its comorbidities. Gestational age at diagnosis may not be a prognostic predictor.
