Refractory congenital chylous ascites.

Area of Science:

• Pediatric Surgery
• Neonatal Medicine
• Lymphatic Imaging

Background:

• Congenital chylous ascites (CCA) is a rare condition in newborns, characterized by lymphatic fluid accumulation in the abdomen.
• Refractory cases pose significant management challenges due to the lack of a defined gold standard treatment.
• Existing treatments have variable success rates, necessitating novel approaches for persistent cases.

Observation:

• A case of refractory congenital chylous ascites in a newborn is presented.
• The condition persisted despite initial management attempts, necessitating advanced diagnostic and therapeutic strategies.

Findings:

• Preoperative lower-limb lymphoscintigraphy accurately identified lymphatic leakage.
• Intraoperative patent blue dye testing and application of fibrin glue facilitated targeted surgical repair.
• This combined approach resulted in a successful clinical outcome for the infant.

Implications:

• This case highlights the efficacy of a multimodal surgical approach for refractory congenital chylous ascites.
• Lymphoscintigraphy and intraoperative dye testing are valuable tools for diagnosing and managing CCA.
• Fibrin glue application represents a viable adjunct in surgical repair, potentially improving outcomes in complex neonatal lymphatic disorders.