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Pediatric Gastroenterology, Hepatology & Nutrition ; : 594-600, 2019.
Artículo en Inglés | WPRIM | ID: wpr-760880

RESUMEN

With improving survival of children with complex congenital heart disease (CCHD), postoperative complications, like protein-losing enteropathy (PLE) are increasingly encountered. A 3-year-old girl with surgically corrected CCHD (ventricular inversion/L-transposition of the great arteries, ventricular septal defect, pulmonary atresia, post-double switch procedure [Rastelli and Glenn]) developed chylothoraces. She was treated with pleurodesis, thoracic duct ligation and subsequently developed chylous ascites and PLE (serum albumin ≤0.9 g/dL) and was malnourished, despite nutritional rehabilitation. Lymphangioscintigraphy/single-photon emission computed tomography showed lymphatic obstruction at the cisterna chyli level. A segmental chyle leak and chylous lymphangiectasia were confirmed by gastrointestinal endoscopy, magnetic resonance (MR) enterography, and MR lymphangiography. Selective glue embolization of leaking intestinal lymphatic trunks led to prompt reversal of PLE. Serum albumin level and weight gain markedly improved and have been maintained for over 3 years. Selective interventional embolization reversed this devastating lymphatic complication of surgically corrected CCHD.


Asunto(s)
Niño , Preescolar , Femenino , Humanos , Adhesivos , Arterias , Procedimientos Quirúrgicos Cardíacos , Quilo , Ascitis Quilosa , Embolización Terapéutica , Endoscopía Gastrointestinal , Cardiopatías Congénitas , Defectos del Tabique Interventricular , Ligadura , Anomalías Linfáticas , Linfografía , Pleurodesia , Complicaciones Posoperatorias , Enteropatías Perdedoras de Proteínas , Atresia Pulmonar , Rehabilitación , Albúmina Sérica , Conducto Torácico , Tomografía Computarizada de Emisión , Aumento de Peso
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