TY - JOUR T1 - Management of large congenital chylous ascites in a preterm infant: fetal and neonatal interventions JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2020-235849 VL - 13 IS - 9 SP - e235849 AU - Loo Sooklin AU - Amudha Jayanthi Anand AU - Victor Samuel Rajadurai AU - Suresh Chandran Y1 - 2020/09/01 UR - http://casereports.bmj.com/content/13/9/e235849.abstract N2 - Congenital chylous ascites is a rare cause of ascites in newborn infants. Its aetiology varies from localised leaky lymphatic duct to genetic syndromes. Most of these cases have transient ascites resolving over time with conservative management but some may progress needing medical as well as surgical treatment. We describe a case of antenatally detected large fetal ascites necessitating abdominal paracentesis and amnioreduction. Marked respiratory distress at birth required urgent abdominal paracentesis to relieve symptoms. The infant initially showed a good response to medium chain triglyceride (MCT) based formula milk feeds. Feeds were discontinued for 3 weeks due to sepsis with ileus. On recovery, recommencement of feeds resulted in reaccumulation of ascites. As the response to MCT-based formula was inadequate, octreotide therapy was initiated. Ascites showed remarkable resolution over the next 2 weeks and was discharged home. Follow-up at 5 years of age revealed normal growth and neurodevelopment. ER -