Congenital Chylous Ascites Associated with Polycystic Kidney Disease: A Case Report
DOI:
https://doi.org/10.35790/ecl.v14i1.63866Keywords:
congenital chylous ascites; polycystic kidney disease; neonate; lymphatic obstruction; ascitic fluid analysisAbstract
Abstract: Congenital chylous ascites is a rare condition caused by abnormalities in the lymphatic system, leading to the leakage of triglyceride-rich lymphatic fluid into the peritoneal cavity. The etiologies include congenital lymphatic malformations, lymphatic obstruction, or increased intra-abdominal pressure. Polycystic kidney disease (PKD) is suspected to impair lymphatic drainage due to elevated intra-abdominal pressure, causing chylous fluid accumulation.. We reported a 16-day-old female neonate born via cesarean section at 38 weeks of gestation due to hydrops fetalis. The infant presented with progressive abdominal distension. Abdominal ultrasound revealed massive ascites, a cystic mass in the left adnexa, and bilateral polycystic kidneys, suggesting secondary lymphatic obstruction. Babygram imaging confirmed significant abdominal distension without intestinal obstruction or skeletal anomalies. Ascitic fluid analysis confirmed its chylous nature, with no signs of malignancy or active infection. Laboratory tests revealed mild anemia, hypoalbuminemia, and elevated inflammatory markers.The underlying pathophysiology in this case suggests that PKD led to secondary lymphatic obstruction due to increased intra-abdominal pressure. The patient underwent ascites drainage using a pigtail catheter, fluid and electrolyte management, analgesics, and antibiotics. After 10 days post-intervention, the infant's condition showed gradual improvement, with reduced abdominal distention, stable respiratory function, and no signs of infection or further complications. In conclusion, congenital chylous ascites in neonates may be secondary to conditions like PKD, which cause lymphatic drainage impairment. Early diagnosis and comprehensive management are essential to prevent long-term complications and optimize outcomes in affected neonates.
Keywords: congenital chylous ascites; polycystic kidney disease; neonate; lymphatic obstruction; ascitic fluid analysis
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