scholarly journals Congenital chylous as cites in a 3-month-old infant in Zaria: A case report

2021 ◽  
Vol 48 (2) ◽  
pp. 96-98
Author(s):  
S.M. Abdullahi ◽  
H.W. Idris ◽  
S.M. Mado ◽  
A.H. Sadiku ◽  
A. Alfa ◽  
...  
Keyword(s):  
Case Report ◽  
Lymphatic System ◽  
Medium Chain Triglyceride ◽  
Chylous Ascites ◽  
Individual Therapy ◽  
Medium Chain ◽  
Diagnosis And Therapy ◽  
Nutrition Medium ◽  
Per Oral ◽  
Abdominal Paracentesis

Congenital chylous ascites (CCA) is a rare disease that results from the maldevelopment of the intra-abdominal lymphatic system. Due to the rarity of congenital chylous ascites and the lack of standards in diagnosis and therapy, this disease constitutes a medical challenge and individual therapy seems to be extremely important. A 3-month-old girl diagnosed with congenital chylous ascites. She was managed initially with nil per oral, parenteral nutrition, medium chain triglyceride (MCT) containing oil and abdominal paracentesis, followed by octreotide. Medium chain triglyceride formula, the main stay of management was discontinued with gradual reintroduction of breast feeds. This case was selected due to the rarity of CCA and the lack of standards in the diagnosis and therapy.

Refractory primary intestinal lymphangiectasia effectively managed with subcutaneous octreotide

2021 ◽  
Vol 14 (4) ◽  
pp. e238457
Author(s):  
Amir Halim ◽  
Philippa Youd ◽  
Jill Thorpe ◽  
Irfan Halim
Keyword(s):  
Case Report ◽  
Gastrointestinal Symptoms ◽  
Medium Chain Triglyceride ◽  
Well Being ◽  
Intestinal Lymphangiectasia ◽  
Curative Therapy ◽  
Medium Chain ◽  
History Of ◽  
Medium Chain Triglyceride Diet ◽  
Conventional Medium

This case report describes a young man with a history of lymphoedema and long-standing gastrointestinal symptoms since childhood. After undergoing extensive investigations, he was diagnosed with primary intestinal lymphangiectasia (IL). The patient’s condition was refractory to conventional medium-chain triglyceride diet but responded well to treatment with subcutaneous octreotide. We have shown octreotide to be effective in improving the pathological effects of primary IL, associated with improved clinical well-being and serology, but it is not a curative therapy.

scholarly journals Congenital chylous ascites: a case report

2019 ◽  
Vol 6 (5) ◽  
pp. 2203
Author(s):  
Rajsree Sreedevi ◽  
Jose Paul ◽  
George Jose ◽  
Abdul Majeed
Keyword(s):  
Case Reports ◽  
Chylous Ascites ◽  
Individual Therapy ◽  
Long Chain Fatty Acids ◽  
Formula Milk ◽  
Management Plans ◽  
Gradual Introduction ◽  
Late Preterm Newborn ◽  
Per Oral

Due to the rarity of congenital chylous ascites and the lack of standards in diagnosis and therapy, this disease constitutes a medical challenge and individual therapy seems to be extremely important. A late preterm newborn with antenatally diagnosed ascites was born and chylous ascites was diagnosed after feeds were started. The baby was managed initially with nil per oral, parenteral nutrition and octreotide, followed by adding MCT formula feeds. Considering the rarity of neonatal chylous ascites and the non-uniformity in management plans and follow up, more case reports need to be published. Also, MCT formula, the main stay of management has to be discontinued as soon as possible with gradual introduction into breast feeds or normal newborn formula milk as long chain fatty acids are essential for optimal brain growth in newborns. 

scholarly journals Successful Ocreotide and Medium-Chain Triglyceride Therapy for Cylothorax in a Patient with Noonan Syndrome: Case Report

2010 ◽  
Vol 30 (4) ◽  
pp. 1402-1405
Author(s):  
Sumru BEDER ◽  
Zinet Gül ERSOY ◽  
Emine GÜLLÜ ◽  
G. Eda UTINE ◽  
Oya KAYACAN ◽  
...  
Keyword(s):  
Case Report ◽  
Noonan Syndrome ◽  
Medium Chain Triglyceride ◽  
Medium Chain

A case report of refractory congenital chylous ascites in infant – surgical treatment with Fibrin glue

2021 ◽  
Vol 148 (12) ◽  
pp. 128-133
Author(s):  
Nguyen Van Tinh ◽  
Nguyen Thi Viet Ha ◽  
Dang Thuy Ha ◽  
Le Dinh Cong ◽  
Vu Manh Hoan ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Fibrin Glue ◽  
Medium Chain Triglyceride ◽  
Chylous Ascites ◽  
Abnormal Development ◽  
Bowel Rest ◽  
No Gold Standard ◽  
Abdominal Paracentesis

Congenital chylous ascites is a rare disease that results from abnormal development of the intra-abdominal lymphatic system. No gold standard treatment has been described so far, however, a combination of medium–chain triglyceride based diet or total parenteral nutrition along with octreotide and abdominal paracentesis is considered as a conservative management. This treatment is often a challenge to physicians since chylous ascites is often refractory and result in malnutrition and immune deficiency because of the loss of proteins and lymphocytes. We report a four-month old boy with congenital chylous ascites who was refractory to medical treatment with prolonged bowel rest, total parenteral nutrition, octreotide and repeated paracentesis. The baby well responded to surgical treatment with application of fibrin glue on the surface area of the leak site and was discharged after 2 month of hospitalization. When following up the patient had no recurrence of the ascites and he was growing up normally.

scholarly journals Use of Sirolimus in a Premature Neonate With Kaposiform Hemangioedema

2021 ◽  
Vol 26 (2) ◽  
pp. 205-209
Author(s):  
Jason Koury ◽  
Miel Brown ◽  
Suzzette Sturtevant ◽  
Cody Wiley ◽  
Linda Felton
Keyword(s):  
Case Report ◽  
Treatment Option ◽  
Medium Chain Triglyceride ◽  
Lesion Size ◽  
Premature Neonate ◽  
High Morbidity ◽  
Kaposiform Hemangioendothelioma ◽  
Medium Chain ◽  
Trough Concentrations ◽  
D Dimer

Kaposiform hemangioendothelioma (KHE) is a rare, vascular malignancy that is often associated with coagulopathies and thrombocytopenia secondary to platelet trapping. Typically, a person diagnosed with KHE with Kasabach-Merritt phenomenon (KMP) presents with a reddish-purplish lesion, thrombocytopenia, and elevated D-dimer, which can lead to high morbidity and mortality. Sirolimus has been identified as a treatment option for KHE with or without KMP for reduction in lesion size and hematologic parameters. In this case report, a female born at 26.5 weeks was noted at birth to have a purpuric lesion on her right upper back and flank area. She was diagnosed with biopsy-confirmed KHE with KMP. She was started on sirolimus 0.01 mg (0.02 mg/kg; 0.14 mg/m2) once a day, and because of high trough concentrations treatment was held until concentrations decreased. Sirolimus was then microdiluted to a 0.01 mg/mL concentration in medium-chain triglyceride oil for administration. Prior to discharge from the hospital the commercially available product was dispensed for home use. After 6 months of treatment, she achieved a reduction in lesion size and improvement in hematologic parameters, and treatment was stopped at 9 months.

Management of large congenital chylous ascites in a preterm infant: fetal and neonatal interventions

2020 ◽  
Vol 13 (9) ◽  
pp. e235849
Author(s):  
Loo Sooklin ◽  
Amudha Jayanthi Anand ◽  
Victor Samuel Rajadurai ◽  
Suresh Chandran
Keyword(s):  
Newborn Infants ◽  
Medium Chain Triglyceride ◽  
Chylous Ascites ◽  
Normal Growth ◽  
Genetic Syndromes ◽  
Formula Milk ◽  
Lymphatic Duct ◽  
Octreotide Therapy ◽  
Abdominal Paracentesis

Congenital chylous ascites is a rare cause of ascites in newborn infants. Its aetiology varies from localised leaky lymphatic duct to genetic syndromes. Most of these cases have transient ascites resolving over time with conservative management but some may progress needing medical as well as surgical treatment. We describe a case of antenatally detected large fetal ascites necessitating abdominal paracentesis and amnioreduction. Marked respiratory distress at birth required urgent abdominal paracentesis to relieve symptoms. The infant initially showed a good response to medium chain triglyceride (MCT) based formula milk feeds. Feeds were discontinued for 3 weeks due to sepsis with ileus. On recovery, recommencement of feeds resulted in reaccumulation of ascites. As the response to MCT-based formula was inadequate, octreotide therapy was initiated. Ascites showed remarkable resolution over the next 2 weeks and was discharged home. Follow-up at 5 years of age revealed normal growth and neurodevelopment.

Surgical treatment of alveolar echinococcosis: a single centre experience and systematic review of the literature

2019 ◽  
Vol 98 (4) ◽  
pp. 167-173
Keyword(s):  
Case Report ◽  
Echinococcus Multilocularis ◽  
Alveolar Echinococcosis ◽  
Lymphatic System ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Safety Margin ◽  
Surgical Removal ◽  
Single Centre Experience ◽  
Therapeutic Procedures

Introduction: Alveolar echinococcosis (AE) is a zoonosis caused by Echinococcus multilocularis. AE is primarily localised in the liver. Echinococcus multilocularis imitates tumour-like behaviour. It can metastasise through blood or lymphatic system to distant organs. Echinococcosis often remains asymptomatic due to its long incubation period and indistinct symptoms. Clinical symptoms are determined by the parasite’s location. Diagnosis of echinococcosis is based on medical history, clinical symptoms, laboratory tests, serology results, imaging methods and final histology findings. Surgical removal of the cyst with a safety margin, followed by chemotherapy is the therapeutic method of choice. Case report: We present a case report of alveolar echinococcosis in a thirty-year-old female patient in whom we surgically removed multiple liver foci of alveolar echinococcosis. The disease recurred after two years and required another surgical intervention. Conclusions: Alveolar echinococcosis is a disease with a high potential for a complete cure provided that it is diagnosed early and that the recommended therapeutic procedures are strictly adhered to.

scholarly journals Combined Chylothorax and Chylous Ascites Complicating Liver Transplantation: A Report of a Case and Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Tommy Ivanics ◽  
Semeret Munie ◽  
Hassan Nasser ◽  
Shravan Leonard-Murali ◽  
Atsushi Yoshida ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Enteral Feeding ◽  
Early Recognition ◽  
Medium Chain Triglyceride ◽  
Serum Triglyceride ◽  
Chylous Ascites ◽  
Abdominal Distension ◽  
Invasive Treatment ◽  
Management Options ◽  
Early Enteral Feeding

Chyle leaks may occur as a result of surgical intervention. Chyloperitoneum, or chylous ascites after liver transplantation, is rare and the development of chylothorax after abdominal surgery is even more rare. With increasingly aggressive surgical resections, particularly in the retroperitoneum, the incidence of chyle leaks is expected to increase in the future. Here we present a unique case of a combined chylothorax and chyloperitoneum following liver transplantation successfully managed conservatively. Risk factors for chylous ascites include para-aortic manipulation, extensive retroperitoneal dissection, use of a Ligasure device, and early enteral feeding as well as early enteral feeding. The clinical presentation is typically insidious and may include painless abdominal distension. Diagnosis can be made by noting characteristic milky white drainage which on laboratory examination has a total fluid triglyceride level >110 mg/dl, an ascites/serum triglyceride ratio of >1 and a leukocyte count in fluid >1000/uL with a lymphocyte predominance. Chyle leaks may lead to significant morbidity and mortality. Numerous management options exist, with conservative nonoperative measurements leading to the most consistent and successful outcomes. This includes a step-up approach beginning with dietary modifications to a low-fat or medium chain triglyceride diet followed by nil per os with addition of total parenteral nutrition and somatostatin analogues such as octreotide. Rarely do patients require more invasive treatment. Early recognition and appropriate management are imperative to mitigate this complication.

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