Chylous ascites: a rare complication of vagotomy. Case report.
A previously healthy 30-year-old man underwent vagotomy and pyloroplasty for a chronic duodenal ulcer that had not responded to H2 blockers. On the third day his abdomen was slightly distended; this gradually increased and on the eighth day ascites was confirmed by ultrasonography. Paracentesis yielded 4 litres of milky, odorless fluid. He was treated by fat free diet as he refused parenteral nutrition and on day 15 a further two litres of fluid were withdrawn, this time straw coloured. By day 31 his abdomen had returned to normal and his serum albumin concentration (which had dropped to 26 g/l) had risen to 43 g/l. He has now remained well for two years. Chylous ascites is a rare complication of truncal vagotomy, but should be suspected if postoperative ascites develops. Early recognition and treatment are important.
Department of Surgery, Mubarak Al-Kabeer Hospital, Kuwait.
M
M
al-Mousawi
T
T
Abu-Nema
D000328:Adult; D002908:Chronic Disease; D002915:Chylous Ascites / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D004322:Drainage; D004381:Duodenal Ulcer / Q000601:surgery; D006801:Humans; D008297:Male; D012709:Serum Albumin / Q000032:analysis; D014463:Ultrasonography; D015167:Vagotomy, Truncal / Q000009:adverse effects*
D012709:Serum Albumin