Open AccessRefractory congenital chylous ascites: Role of fibrin glue in its management
Author(s) -
Rahul Saxena,
Biangchwadaka Suchiang,
Manish Pathak,
Arvind Sinha
Publication year - 2020
Publication title -
journal of indian association of pediatric surgeons
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.306
H-Index - 17
eISSN - 1998-3891
pISSN - 0971-9261
DOI - 10.4103/jiaps.jiaps_123_19
Subject(s) - chylous ascites , medicine , octreotide , lymph , lymphatic system , parenteral nutrition , chyle , fibrin glue , ascites , surgery , pathology , complication , somatostatin
Chylous ascites is the accumulation of triglyceride-rich lymph in the abdomen. Its occurrence during the infantile period is quite rare. Congenital chylous ascites (CCA) is one, which occurs in children <3 months of age, due to maldevelopment of the lymphatic system. There is no clearly defined treatment protocol for CCA; however, the use of medium-chain triglycerides (MCT)-based diet or total parenteral nutrition (TPN) with octreotide has been successful. Failure of conservative management, however, leads to surgical exploration to deal with those leaking lymphatics. In our case, we had initially given a trial of managing the child with MCT-based diet followed by a TPN along with octreotide. However, the failure of both leads us to operate the child during which we incorporated the use of fibrin glue over the leaking mesenteric lymphatic vesicles, which ultimately led to the resolution of the chylous ascites.