Chylous ascites in infants

Chylous ascites is an uncommon condition in infants caused by a variety of congenital or acquired abnormalities responsible for obstruction and distension of the mesenteric lymphatics. Case-reports. Case 1. A 30-month-old boy was admitted for gradual abdominal distension with edema of the right upper limb. Aspiration of the peritoneal cavity recovered milky fluid. An ultrasound scan of the abdomen disclosed a-cystic multiloculated lesion suggestive of-a cystic lymphangioma. The outcome was favorable after repeated aspiration of the peritoneal cavity under ultrasound guidance and aspiration of the cyst. Case 2. A 27-month-old boy was admitted for fever, a cough, a decline in general health, anasarca, and peripheral lymphadenopathy. PI Milky fluid was recovered by aspiration of the peritoneal cavity. The intradermal tuberculin test was positive. The patient recovered after treatment with a combination of three antituberculous agents. Case 3. A 36-year-old girl was admitted for intermittent fever with dyspnea, abdominal distension, and edema of the lower limbs. The dependent areas of the abdomen were flat to percussion. Aspiration of the abdominal cavity recovered milky fluid. The tuberculin skin test was positive. The outcome was favorable after conventional antituberculous therapy. Case 4. A 3-year-old boy was admitted for intermittent fever with labored breathing, a decline in general health, and a distended abdomen with dependent flatness to percussion. His father was receiving treatment for tuberculosis. The tuberculin skin test was positive. Milky fluid was recovered by aspiration of the peritoneal cavity. The clinical and laboratory test abnormalities resolved under antituberculous therapy. Conclusion. These four case-reports illustrate the problems raised by the management of chylous ascites and its causes in infants living in areas where health care resources are limited.