European Journal of Pediatrics

, Volume 151, Issue 3, pp 213–214 | Cite as

Chylous ascites: total parenteral nutrition as primary therapeutic modality

  • P. Alliët
  • C. Young
  • E. Lebenthal


A female infant with Down syndrome and congenital chylous ascites presented at birth with respiratory distress secondary to marked abdominal distension. Total parenteral nutrition (TPN) and paracentesis were the primary therapeutic modality. On hyperalimentation, however, ascites initially recurred, requiring additional paracenteses to improve respiratory distress. The chylous ascites, lymphopenia and hypoalbuminemia were relieved after 10 weeks of TPN administration. We recommend a long-term course (10 weeks) of TPN before an exploratory laparatomy and possible surgical intervention are considered.

Key words

Down syndrome Chylous ascites Total parenteral nutrition 



total parenteral nutrition


  1. 1.
    Asch MJ, Sherman NJ (1979) Management of refractory chylous ascites by total parenteral nutrition. J Pediatr 94:260–262PubMedGoogle Scholar
  2. 2.
    Bach AC, Babayan VK (1982) Medium-chain triglycerides: an update. Am J Clin Nutr 36:950–962PubMedGoogle Scholar
  3. 3.
    Cochran WJ, Klish WJ, Brown MR, Lyons JM, Curtis T (1985) Chylous ascites in infants and children: a case report and literature review. J Pediatr Gastroenterol Nutr 4:668–753Google Scholar
  4. 4.
    Cronk CE (1978) Growth of children with Down's syndrome: birth to age 3 years. Pediatrics 61:564–568PubMedGoogle Scholar
  5. 5.
    McKendry JBJ, Lindsay WK, Gerstein MC (1957) Congenital defects of the lymphatics in infancy. Pediatrics 19:21–34PubMedGoogle Scholar
  6. 6.
    Press OW, Press NO, Kaufman SD (1982) Evaluation and management of chylous ascites. Ann Intern Med 96:358–364PubMedGoogle Scholar
  7. 7.
    Ruhrah J (1934) A note on the history of chylous ascites. Am J Dis Child 47:629–631Google Scholar
  8. 8.
    Smeltzer DM, Stickler GB, Fleming RE (1986) Primary lymphatic dysplasia in children: chylothorax, chylous ascites, and generalized lymphatic dysplasia. Eur J Pediatr 145:286–292PubMedGoogle Scholar
  9. 9.
    Sturmer FC (1965) Infantile chylous ascites: review of literature and case report. Am Surg 31:281–284PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • P. Alliët
    • 1
  • C. Young
    • 1
  • E. Lebenthal
    • 2
  1. 1.Division of Gastro-enterology and NutritionChildren's HospitalBuffaloUSA
  2. 2.Department of PediatricsHahnemann School of MedicinePhiladelphiaUSA

Personalised recommendations