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Chyloperitoneum in a toddler on peritoneal dialysis
Veronica Lavelle Bell1, Alyssa A Schlotman1, Daniel J Benedetti1,2
1Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, 2200 Children's Way, Nashville, TN, 37232-9560, USA.
Chyloperitoneum, a rare condition in peritoneal dialysis (PD) patients, was diagnosed in a toddler with milky dialysate. This case highlights the importance of investigating abdominal malignancy in pediatric PD patients presenting with chyloperitoneum.
Area of Science:
- Nephrology
- Pediatric Oncology
- Gastroenterology
Background:
- Chyloperitoneum is an infrequent complication in peritoneal dialysis (PD) patients.
- In adults, it can signal serious conditions like malignancy or organ disease.
- Pediatric cases often link to recent procedures disrupting lymphatic vessels.
Purpose of the Study:
- To report a unique case of chyloperitoneum in a pediatric PD patient.
- To investigate the underlying cause of chyloperitoneum in this specific patient.
- To emphasize the diagnostic importance of chyloperitoneum in pediatric PD.
Main Methods:
- A 16-month-old male on PD presented with symptoms of emesis and feeding intolerance.
- Milky dialysate and elevated triglycerides confirmed chyloperitoneum.
- Abdominal investigation revealed multifocal hepatoblastoma.
Main Results:
- The patient's chyloperitoneum resolved following chemotherapy and a medium-chain triglycerides (MCTs)-based diet.
- The underlying cause was identified as multifocal hepatoblastoma.
- This contrasts with typical pediatric PD-associated chyloperitoneum causes.
Conclusions:
- Abdominal malignancy should be considered in pediatric PD patients with chyloperitoneum.
- Prompt and thorough evaluation is crucial for timely diagnosis and treatment.
- Multifocal hepatoblastoma can present with chyloperitoneum in pediatric PD patients.
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