Treatment of neonatal chylous ascites using a modified Denver peritoneovenous shunt: a case report

Chylous ascites is rarely observed in newborns. Its etiology is not always readily identifiable. The authors report a patient with idiopathic chylous ascites resistant both to conservative treatment with total parenteral nutrition plus diuretics and to dietary treatment (milk with a low-fat content and medium-chain triglycerides). Surgical correction of an associated intestinal malrotation and an annular pancreas failed to resolve the ascites and we therefore placed a modified Denver peritoneovenous shunt. Six months after placement of the shunt, the patient was in good general condition, with restoration of normal oral feeding and regular growth in terms of height and weight. Clinical and ultrasonographic follow-up examinations have not revealed the presence of ascitic fluid in the peritoneal cavity.