Necrotizing enterocolitis as a side effect of octreotide in a preterm neonate, a case report

Abstract

Congenital chylous ascites (CCA) is a rare disease, characterized by accumulation of chyle in the peritoneal cavity in infants <3 months. Respiratory distress and abdominal distension at birth are common presentations of CCA. Treatment of CCA includes abdominal paracentesis, medium-chain triglyceride (MCT) formula, total parenteral nutrition (TPN), and administration of octreotide. Surgical treatment is considered in case of conservative treatment failure. Octreotide administration leads to a reduction in the flow of chyle and predisposes high-risk infants to necrotizing enterocolitis (NEC). We present a case of CCA in a preterm neonate that developed necrotizing NEC, 2 days after initiation of intravenous octreotide. Despite the immediate cessation of octreotide and surgical and supportive treatment, the infant was expired so we suspect that octreotide was a risk factor for the development of NEC in our patient and this report aims to warn this association and suggest that if octreotide is used in treatment, the patient must be under close monitoring for any signs of NEC.

Keywords

• Congenital chylous ascites
• Octreotide
• Necrotizing enterocolitis