Chylous ascites after an H-graft interposition mesocaval shunt.
A case of chylous ascites occurring after an emergency mesocaval shunt is reported. After an attempt at conservative management had failed, the patient was surgically explored. Although a lymphatic leak could not be identified, oversewing the retroperitoneum in the area of previous dissection and reinforcement with an omental pedicle was successful in preventing postoperative reaccumulation of chylous ascites. A review of the 26 reported cases of postoperative chylous ascites indicates a spontaneous resolution rate of 41% with non-operative management including low fat diet, paracenteses, and total parenteral nutrition. If conservative measures fail, surgical repair of the traumatised lymphatic bed has been successful.
D000328:Adult; D002915:Chylous Ascites / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery*; D008722:Methods; D011183:Postoperative Complications / Q000601:surgery; D014682:Vena Cava, Inferior / Q000601:surgery*