F. Varrone

G. Marzocca

M. Lo Gatto

Undetermined

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84ABSTRACTS OF ANNUAL SCIENTIFIC MEETING OF THE ACCADEMYAnnual scientific meeting May 25 2011CHYLOUS ASCITES: CASE REPORTLo Gatto M., Varrone F., Marzocca G.Department of Surgery and Surgical SpecialitiesUniversity of Siena, Italy.IntroductionMost of the diseases of the lymphatic vessels chiliferi chylousreflux are related to gravitational dysplasia of lymphatic col-lectors  and  Chilosi,  with  parieto-valveinsufficiency.  It is,however, of paintings relatively rare, occurring in most cas-esalready  in the newborn  or  child,  in relation to extentand severity of malformations lymphangitis-chilodisplasticthat underlie these complex pathological manifestations. Thechylous ascites is a rare clinical  manifestation of chylous’vessel pathology. The authors present a case report of chy-lous  ascites,  which classification is performed during ex-ploratory laparotomy, because  the  CT images gavea framework for doubt bowel infarction.Materials and Methods. B.A.,  a woman of  84 years,  ar-rives at our Unit, sent from the emergency department foracute abdomen.Discussion. Are no epidemiological data reported in litera-ture relating to diseases of the thoracic duct of cysterna chyliintestinal vessels and, in particular as regards theforms dys-plasia.Conclusions. The chylous ascites is often a difficult diagnosisto make clinically, CT often shows a picture  comparable. Ei-dological intestinal infarction in case of acute abdomen, asthe case report  presented by the authors, and the suspicionof a bowel infarction, the Surgeon just have to   perform anexploratory laparotomy with a diagnosis of chylous ascitesand  its  drainage,  with  a high risk of death from cardio-cir-culatory failure.Keywords: Chylous ascites, case report.OFF-LABEL USE OF PAMIDRONATE IN HYPER-CALCEMIC NEWBORN AFFECTED BY SUBCUTA-NEOUS FAT NECROSIS AFTER THERAPEUTICHYPOTERMIARodriquez D, Bertrando S, Cornacchione S, CovielloC, Stazzoni G, Tei M, Perrone S, Buonocore G.Department of Pediatrics, Obstetrics andReproductive Medicine, University of Siena, Italy.Background: Subcutaneous fat necrosis is a dermatologicaldisorder with characteristic subcutaneous nodules orplaques. It has a benign nature and generally runs a self-lim-iting course, although can cause significant  and dangerouscomplications, including hypercalcemia. Outbreak of hyper-calcemia occurs even several months after hypothermic treat-ment in asymptomatic or symptomatic way. Irritability,lethargy, hypotonia, emesis, polyuria, polydipsia, constipa-tion and failure to thrive are the most common symptoms ofhypercalcemia while seizures, cardiac arrest and acute orchronic renal failure are the most serious manifestations.Chronic hypercalcemia is also associated with nephrocalci-nosis and metastatic calcifications of skin, heart, lever andvessels.Low calcium and vitamine D formula preparation milk, di-uretics, such as furosemide, and corticosteroids are first-linetreatments. In some refractory case pamidronate is used.Pamidronate is a biphosphonate which can modulate boneturnover by leading hydroxyapatite crystals, and it can in-hibit osteoclastic bone resorption.Observation: A male full-term infant weighing 2,300 gramswas born after an emergency cesarean section due to fetalheart rate decelerations. His initial Apgar scores were 1 at 1minute, 4 at 5 minutes and 8 at 15 minutes. Due to hypoxic-ischaemic encephalopathy (stage 1 of Sarnat classification,with abnormal voltage and paroxysmal activities at elec-troencephalogram),a whole-body therapeutic hypothermiawas initiated before sixth hour of life. It was performed to atarget rectal temperature of 33,5°C, for about 36 hours. In thethird day of life, he developed characteristic subcutaneous fatnecrosis skin lesions, such as firm, indurated plaques and redand violaceous nodules, on the upper back area and buttocks. One month after the hypotermic treatment the infant devel-oped a rapid, asymptomatic increase of  calcemia. First hismilk was changed to a very low calcium and vitamin D for-mula preparation, without a clinical improvement. Hypercal-cemia (total serum calcium 13,8 mg/dL [reference range9-10.9 mg/dL] and ionized calcium 1,96 mmol/L [referencerange 1,12-1,32 mmol/L]) was successfully treated with a 3-days therapy of intravenous pamidronate at dose of 0,5mg/kg/die. No side effects were detected during the treatment and  thenserum calcium levels remained stable.Annual scientific meeting November 7 2011

CHYLOUS ASCITES: CASE REPORT

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CHYLOUS ASCITES: CASE REPORT

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