Neonatal Medicine

The Korean Society of Neonatology (대한신생아학회)
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Umbilical Venous Catheter Complication Presenting as Chylous Ascites in a Newborn: Intraperitoneal Extravasation of Total Parenteral Nutrition Infusate

  • Lee, Hye Mi (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Sung, Hyun Jung (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Lee, Hyun-Seung (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
  • Received : 2018.09.03
  • Accepted : 2018.10.24
  • Published : 2018.11.30
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Abstract

Umbilical venous catheterization (UVC) is a common practice in intensive neonatal care. However, a malpositioned UVC and its prolonged use may lead to various problems, including mechanical, infectious, and thrombotic complications in various organs such as the liver, lungs, and heart. Congenital chylous ascites is characterized by abnormally high levels of triglycerides in the peritoneal fluid of newborns, which originate from refluxed lymph within the abdominal cavity. Herein, we report a case of an UVC complication presenting as chyloperitoneum simulating congenital chylous ascites in a preterm neonate that resulted from total parenteral nutrition (TPN) extravasation from a malpositioned UVC. Biochemical analysis of intraperitoneal chylous fluid and TPN infusate could help confirm the origin of chyloperitoneum. This case suggests that TPN extravasation from UVC should be considered when chyloperitoneum develops in newborns with an indwelling catheter. UVC positions must also be carefully monitored at regular intervals to recognize associated complications early, particularly in cases with an inevitably malpositioned catheter related to the anatomy of the vessel course.

Keywords

References

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  1. Parenteral Nutrition Ascites: Calamity from an Umbilical Vein Cannula vol.10, pp.1, 2018, https://doi.org/10.1055/s-0040-1720957