{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:38:28Z","timestamp":1760146708050,"version":"build-2065373602"},"reference-count":15,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: The use of point-of-care ultrasound (POCUS) in emergency departments is rapidly growing due to its ability to provide immediate and accurate diagnostic information at the bedside. Furthermore, it can provide precise and rapid information on the location of multidistrict effusions in patients with suspected lymphatic decompensation. Case Presentation: This unique clinical case report describes a patient who presented with massive, multidistrict chylous effusion secondary to acute lymphatic insufficiency, a rare and challenging condition. Due to a recent diagnosis of celiac disease, the patient had started a gluten-free diet ten days before the onset of symptoms, suggesting a possible causal link. Through comprehensive thoracoabdominal POCUS, the diagnosis was made promptly, avoiding delays in treatment and enabling timely decision-making. Conclusions: This case emphasizes the critical role of POCUS not only in expediting diagnosis but also in guiding invasive procedures, such as thoracentesis, by visualizing fluid accumulation and anatomical structures in real-time. Moreover, POCUS provides an invaluable tool for ongoing clinical ultrasound follow-up, facilitating continuous monitoring without exposing the patient to the risks of radiation, thus optimizing patient care and resource utilization.<\/jats:p>","DOI":"10.3390\/reports7040110","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T04:13:03Z","timestamp":1733371983000},"page":"110","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Usefulness of Point-Of-Care Ultrasound in Diagnosing and Managing Pediatric Multidistrict Chylous Effusion"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7559-0111","authenticated-orcid":false,"given":"Tommaso","family":"Bellini","sequence":"first","affiliation":[{"name":"Pediatric Emergency Room and Emergency Medicine Unit, Emergency Department, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Bustaffa","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Room and Emergency Medicine Unit, Emergency Department, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7277-4767","authenticated-orcid":false,"given":"Marco","family":"Crocco","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Endoscopy Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Casabona","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16147 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgia","family":"Iovinella","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16147 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9105-0630","authenticated-orcid":false,"given":"Federica","family":"Malerba","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16147 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0301-5753","authenticated-orcid":false,"given":"Matteo","family":"D\u2019Alessandro","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Room and Emergency Medicine Unit, Emergency Department, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuela","family":"Piccotti","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Room and Emergency Medicine Unit, Emergency Department, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1542\/peds.2013-2072","article-title":"Chylothorax in infants and children","volume":"133","author":"Tutor","year":"2014","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.21037\/jtd-23-7","article-title":"Pediatric chylothorax: Where we\u2019ve been and where we\u2019re going","volume":"15","author":"Winder","year":"2023","journal-title":"J. Thorac. Dis."},{"key":"ref_3","first-page":"108","article-title":"Congenital chylothorax: Current evidence-based prenatal and post-natal diagnosis and management","volume":"52","author":"Bellini","year":"2019","journal-title":"Lymphology"},{"key":"ref_4","first-page":"28","article-title":"Lymphoscintigraphy patterns in newborns and children with congenital lymphatic dysplasia","volume":"47","author":"Bellini","year":"2014","journal-title":"Lymphology"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"P\u00e9rez-Casares, A., Cesar, S., Brunet-Garcia, L., and Sanchez-de-Toledo, J. (2017). Echocardiographic Evaluation of Pericardial Effusion and Cardiac Tamponade. Front. Pediatr., 5.","DOI":"10.3389\/fped.2017.00079"},{"key":"ref_6","first-page":"150","article-title":"Congenital Chylothorax of the Newborn: Diagnosis and Treatment in Three Pictures","volume":"49","author":"Bellini","year":"2016","journal-title":"Lymphology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1159\/000520313","article-title":"\u201cOpen Questions\u201d and Role of Lung Ultrasound in the Management of Congenital Chylothorax","volume":"101","author":"Perri","year":"2022","journal-title":"Respiration"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"97","DOI":"10.24908\/pocus.v6i2.15193","article-title":"The Use of Thoracic Ultrasound to Predict Transudative and Exudative Pleural Effusion","volume":"6","author":"Evans","year":"2021","journal-title":"POCUS J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1016\/j.chest.2020.02.051","article-title":"Diagnostic Accuracy of Thoracic Ultrasonography to Differentiate Transudative from Exudative Pleural Effusion","volume":"158","author":"Shkolnik","year":"2020","journal-title":"Chest"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e300","DOI":"10.1097\/PEC.0000000000002271","article-title":"Use of Cardiac Point-of-Care Ultrasound in the Pediatric Emergency Department","volume":"38","author":"Miller","year":"2022","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1093\/nutrit\/nuad005","article-title":"Nutritional markers accompanying acquired chylothorax in infants: A systematic review","volume":"81","author":"Marzotto","year":"2023","journal-title":"Nutr. Rev."},{"key":"ref_12","first-page":"75","article-title":"Dynamics of pleural fluid effusion and chylothorax in the fetus and newborn: Role of the lymphatic system","volume":"46","author":"Bellini","year":"2013","journal-title":"Lymphology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1186\/s13052-018-0520-y","article-title":"Point of care ultrasonography in the pediatric emergency department","volume":"44","author":"Orlandini","year":"2018","journal-title":"Ital. J. Pediatr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"124","DOI":"10.24908\/pocus.v8i2.16595","article-title":"The Importance of Serial POCUS Exams\u2014Dual Pathologies in Play","volume":"8","author":"Nair","year":"2023","journal-title":"POCUS J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3","DOI":"10.21037\/med-20-64","article-title":"Review of chylopericardium","volume":"6","author":"Rochefort","year":"2022","journal-title":"Mediastinum"}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/7\/4\/110\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:47:16Z","timestamp":1760114836000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/7\/4\/110"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,5]]},"references-count":15,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["reports7040110"],"URL":"https:\/\/doi.org\/10.3390\/reports7040110","relation":{},"ISSN":["2571-841X"],"issn-type":[{"type":"electronic","value":"2571-841X"}],"subject":[],"published":{"date-parts":[[2024,12,5]]}}}