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Congenital chylous ascites: A report of a case treated with hemostatic cellulose and fibrin glue

  • Daniel de Albuquerque Rangel Moreira
    Affiliations
    Pediatric Surgery Division, Pediatric Liver Transplantation Unit, Laboratory of Research in Pediatric Surgery (LIM 30), University of Sao Paulo Medical School, Sao Paulo, Brazil
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  • Maria Merces Santos
    Affiliations
    Pediatric Surgery Division, Pediatric Liver Transplantation Unit, Laboratory of Research in Pediatric Surgery (LIM 30), University of Sao Paulo Medical School, Sao Paulo, Brazil
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  • Ana Cristina Aoun Tannuri
    Affiliations
    Pediatric Surgery Division, Pediatric Liver Transplantation Unit, Laboratory of Research in Pediatric Surgery (LIM 30), University of Sao Paulo Medical School, Sao Paulo, Brazil
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  • Uenis Tannuri
    Correspondence
    Corresponding author. Faculdade de Medicina da Universidade de São Paulo, Avenida Dr. Arnaldo 455, 4o andar sala 4109, São Paulo-SP, CEP: 01246-903, Brazil. Tel.: +55 11 30812943, fax: +55 11 32556285.
    Affiliations
    Pediatric Surgery Division, Pediatric Liver Transplantation Unit, Laboratory of Research in Pediatric Surgery (LIM 30), University of Sao Paulo Medical School, Sao Paulo, Brazil
    Search for articles by this author

      Abstract

      We report a case of an infant with recurrent chylous ascites who was unresponsive to conventional medical treatment. An exploratory laparotomy revealed no macroscopically visible sites of lymph leakage that could be ligated. Lymph exudation was noted in areas near the subhepatic recess and in the lesser sac surrounding the pancreas, which was not amenable to suture. The treatment consisted of the placement of a hemostatic mesh composed of oxidized cellulose (Surgicel®) on these areas, with a thin layer of fibrinogen/thrombin glue over the mesh (Tissucol®). The cellulose mesh allowed for greater adhesion of the fibrin glue to the diseased tissues. The patient had no recurrence of ascites and is currently 20 months old, with good weight-height gain, and free of ascites.

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