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Neonatal Med > Volume 25(4); 2018 > Article
Neonatal Medicine 2018;25(4):196-201.
DOI: https://doi.org/10.5385/nm.2018.25.4.196    Published online November 30, 2018.
Umbilical Venous Catheter Complication Presenting as Chylous Ascites in a Newborn: Intraperitoneal Extravasation of Total Parenteral Nutrition Infusate
Hye Mi Lee, Hyun Jung Sung, Hyun-Seung Lee
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
Corresponding author:  Hyun-Seung Lee, Tel: +82-31-820-3590, Fax: +82-31-821-3108, 
Email: iamlidia@catholic.ac.kr
Received: 3 September 2018   • Revised: 20 October 2018   • Accepted: 24 October 2018
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.
Key Words: Umbilical venous catheter, Chylous ascites, Total parenteral nutrition, Newborn
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