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Chylous ascites after excision of a choledochal cyst in a child

Chun-Chieh Huang1, Ming-Shian Tsai, Hong-Shiee Lai

  • 1Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

Journal of Pediatric Surgery
|May 13, 2009
PubMed

Insights

Chylous ascites, a rare complication after pediatric choledochal cyst surgery, was successfully treated with somatostatin. This finding offers a new therapeutic option for managing similar post-operative cases.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Clinical Case Reports

Background:

  • Choledochal cysts are congenital dilations of the bile ducts.
  • Surgical excision with Roux-en-Y hepaticojejunostomy is the standard treatment.
  • Postoperative complications can include fluid collections, such as chylous ascites.

Observation:

  • A pediatric patient developed chylous ascites two weeks post-operatively after choledochal cyst excision.
  • Initial management with fasting was unsuccessful in resolving the chylous ascites.
  • Intravenous somatostatin administration was initiated for treatment.

Findings:

  • Intravenous somatostatin effectively resolved the chylous ascites in this pediatric patient.
  • No significant adverse side effects were observed during somatostatin therapy.
  • This represents the first reported case of successful somatostatin treatment for post-choledochal cyst excision chylous ascites in children.

Implications:

  • Somatostatin is a potential therapeutic agent for managing pediatric postoperative chylous ascites.
  • This case highlights the utility of somatostatin in challenging surgical complications.
  • Further research may explore somatostatin's role in similar gastrointestinal surgical scenarios.

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