Olivieri Claudio, Nanni Lorenzo, Masini Lucia, Pintus Claudio
Pediatric Surgery Unit, Policlinico A. Gemelli, Rome, Italy.
BMJ Case Rep. 2012 Sep 25;2012:bcr2012006196. doi: 10.1136/bcr-2012-006196.
Congenital chylous ascites (CCA) is a rare disease that results from maldevelopment of the intra-abdominal lymphatic system. Few cases have been described and no gold standard treatment has been defined so far. Octreotide, a somatostatin analogue, has been used for the treatment of CCA, but always after a failed conservative approach with fasting, total parenteral nutrition (TPN) or medium chain triglyceride (MCT) feeds. We report the case of a newborn with CCA treated by fasting, TPN and octreotide for a period of 15 days until the abdominal distension was successfully reduced at which point treatment was switched to an MCT formula. On day 25 the patient was breastfed and was discharged on day 33. No recurrence of chylous ascites was noted. Our experience highlights the successful treatment with TPN and octreotide as the first step for the conservative approach of CCA in a newborn, reducing the length of treatment and hospitalisation.
先天性乳糜腹水（CCA）是一种罕见疾病，由腹腔内淋巴系统发育不良引起。目前报道的病例较少，且尚未确定金标准治疗方法。奥曲肽是一种生长抑素类似物，已用于治疗CCA，但通常是在禁食、全胃肠外营养（TPN）或中链甘油三酯（MCT）喂养等保守治疗方法失败之后。我们报告了一例患有CCA的新生儿病例，通过禁食、TPN和奥曲肽治疗15天，直至腹胀成功减轻，此时治疗改为MCT配方奶。第25天患者开始母乳喂养，并于第33天出院。未发现乳糜腹水复发。我们的经验表明，TPN和奥曲肽作为新生儿CCA保守治疗的第一步取得了成功，缩短了治疗时间和住院时间。
