Chylous ascites complicating pediatric renal transplantation

Chylous ascites (CA) is an unusual complication of pediatric abdominal surgery which can be difficult to manage. Little data are available to guide therapy.

We describe the presentation, clinical course and management of two patients, a 7-year-old boy and 2.5-year-old girl, who experienced CA following intraperitoneal renal transplantation. Both cases failed medical management, and the patients required surgical intervention. One required a peritoneovenous shunt while the other required an external abdominal drain. Both patients eventually experienced resolution of the CA and excellent long-term renal function.

These case descriptions highlight the challenges of optimizing nutrition while controlling chylous output. We also review some of the risk factors associated with CA and draw attention to the consideration of this diagnosis in any renal transplant recipient with post-operative abdominal distention and ascites.