G361 Parental photographic monitoring of ascites

Abstract

Aims Primary Chylous Ascites is a rare cause of abdominal distension in infants. Our patient had six weeks of intravenous octreotide and total parenteral nutrition followed by medium chain triglyceride formula feeding. We describe his monitoring by girth measurement and parental photography. Methods A four week old boy who presented with worsening abdominal distension and discomfort had ultrasound confirmed ascites. At paracentesis, 100 ml of chylous fluid was aspirated. His clinical course was monitored by serial girth measurement and parental photography using a modern mobile telephone. Results Variability in abdominal circumference measurements (Figure 1) made detection of clinical improvement more difficult than it was with serial photography (Figure 2). His mother found the photographs helpful in monitoring her son's progress. Conclusion This superiority of parental photography over formalised girth measurement monitoring in our patient mandates critical review of these techniques. Informal parental photography has been used in assessment of dermatological conditions1 and inguinal hernias.2 Inter-observer variability in measurements of abdominal circumference is recognised.3 Parental photography may increase parents' perceived involvement in their child's care in such chronic treatment and promote a family centred approach. We speculate that measurements from technical photographs4 as employed in sports biomechanical studies5 will be the most sensitive tool for clinical assessment of ascites. (Figure Presented).