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Umbilical venous catheterization (UVC) is a common practice in intensive neonatal care. However, a malpositioned UVC and its prolonged use may lead to various pro­ blems, including mechanical, infectious, and thrombotic complica tions in various organs such as the liver, lungs, and heart. Congenital chylous ascites is characterized by abnormally high levels of triglycerides in the peritoneal fluid of newborns, which originate from refluxed lymph within the abdominal cavity. Herein, we report a case of an UVC complication presenting as chyloperitoneum simulating congenital chylous ascites in a preterm neonate that resulted from total parenteral nutrition (TPN) extra­ vasation from a malpositioned UVC. Biochemical analysis of intraperitoneal chylous fluid and TPN infusate could help confirm the origin of chylo peritoneum. This case suggests that TPN extravasation from UVC should be considered when chyloperito­ neum develops in newborns with an indwelling catheter. UVC posi tions must also be carefully monitored at regular intervals to recognize associated complications early, particularly in cases with an inevitably malpositioned catheter related to the anatomy of the vessel course.

neonatal medicine

Umbilical Venous Catheter Complication Presenting as Chylous Ascites in a Newborn: Intraperitoneal Extravasation of Total Parenteral Nutrition Infusate