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UNUSUAL CASE
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Refractory congenital chylous ascites: First report of fibrin glue and mesh application by laparoscopy


1 Department of Neonatal and Pediatric Surgery, Santokba Durlabhji Memorial Hospital and Research Institute, Jaipur, Rajasthan, India
2 Department of Pediatrics, Santokba Durlabhji Memorial Hospital and Research Institute, Jaipur, Rajasthan, India

Correspondence Address:
Sunita Ojha,
Department of Neonatal and Pediatric Surgery, Santokba Durlabhji Memorial Hospital and Research Institute, Jaipur, Rajasthan
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmas.jmas_228_21

Chylous ascites (CA) is a form of ascites having leakage of lipid-rich lymph into the peritoneal cavity, due to damage or obstruction in the lymphatic system. Aetiology of CA could be congenital or acquired. Primary lymphatic hypoplasia is seen commonly in children and presents with lymphoedema, chylothorax or CA. CA is initially treated conservatively with the aim to provide gut rest and decrease intestinal secretions. Surgical treatment is recommended if 1–2 months of conservative approach fails. The success of the operation depends on identifying the site of leakage of the lymphatic duct. Surgical options are ligation of leaking lymphatics, peritoneo-venous shunt, laparotomy and fibrin glue. Laparoscopy has been used for diagnosis but not for glue and mesh application in congenital CA where the lymphatic leak is unidentified. We present here the first experience of laparoscopic fibrin glue and mesh application in congenital CA with successful outcomes.


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    -  Ojha S
    -  Bharadia L
    -  Chaturvedi A
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2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04