Congenital chylous ascites treated successfully with MCT-Based formula and octreotide

Area of Science:

• Pediatric Gastroenterology
• Neonatal Surgery
• Clinical Case Study

Background:

• Congenital chylous ascites (CCA) is a rare condition characterized by lymphatic fluid accumulation in the abdominal cavity.
• Conventional management includes medium-chain triglyceride (MCT)-based diets, total parenteral nutrition (TPN), and repeated paracentesis.
• Surgical intervention is typically reserved for cases refractory to medical management.

Observation:

• A 2½-month-old infant presented with congenital chylous ascites.
• The infant did not respond to initial conservative therapy, including an MCT-enriched formula and paracentesis.
• Hemodynamic instability was a concern, making oral MCT therapy poorly tolerated.

Findings:

• Intravenous octreotide infusion was administered as an alternative treatment.
• The infant showed a successful clinical response to octreotide therapy.
• This suggests octreotide as a viable option for refractory CCA.

Implications:

• Octreotide may represent a valuable therapeutic option for infants with congenital chylous ascites unresponsive to standard treatments.
• Early consideration of octreotide could potentially avoid invasive surgical procedures.
• Further research is warranted to establish the efficacy and optimal use of octreotide in pediatric lymphatic disorders.