[Chylothorax and chylous ascites following surgery of an inflammatory aortic aneurysm. Case report with review of the literature].
Chylous ascites complicating surgery on the abdominal aorta is infrequent: we report one case associated with right chylothorax, secondary to the surgical cure of an inflammatory aortic aneurysm. Surgery for aneurysms causes 81% of all chylous ascites caused by injuries to the intestinal lymphatics or to their recipients, the left latero-aortic lymph nodes or the cisterna chyli. Upper or extensive dissections of the retroperitoneal space and difficult dissection of ruptured or inflammatory aneurysms are the cisterna chyli. Upper or extensive dissections of the retroperitoneal space and difficult dissection of ruptured or inflammatory aneurysms are the major etiological factors. Stasis and fibrosis, then the rupture of the lymphatics into the aneurysmal wall were described during inflammatory aneurysm: this lymphatic etiology might explain the inflammatory character of these aneurysms and entail a risk of lymphoperitoneal fistula when laying the aneurysmal wall flat. An early diagnosis must be established with paracentesis before any compressive, metabolic, immunological or septic complications occur. Continuous parenteral feeding and selective paracenteses dry out 80% of the postoperative chylous ascites. If the ascites persists after 4 to 6 week's conservative treatment, a peritoneojugular derivation or a direct lymphostasis may be contemplated, according to the patient's condition.
Combe
J
J
Service de Chirurgie Vasculaire, CHU Besançon.
Buniet
J M
JM
Douge
C
C
Bernard
Y
Y
Camelot
G
G
D001012:Aorta, Abdominal / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery*; D002916:Chylothorax / Q000209:etiology*; D002915:Chylous Ascites / Q000209:etiology*; D006801:Humans; D007249:Inflammation / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications
Chylothorax et chyloperitoine après chirurgie d'un anévrysme aortique inflammatoire. Un cas avec revue de la littérature.