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

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. Published by Elsevier Inc.