Chylous ascites after radical nephrectomy and inferior vena cava thrombectomy. Successful conservative management with somatostatin analogue.
Postoperative chylous ascites is a rare complication of retroperitoneal surgery. The treatment of postoperative chylous ascites is primarily conservative, consisting of repeated paraceteses, medium chain triglyceride (MCT) diet, salt restriction, diuretics and bowel rest with total parenteral nutrition. Occasionally, chylous ascites may take a protracted course which may necessitate insertion of peritoneo-venous shunts or direct surgical lymphostasis. Recently, Somatostatin was shown to be highly effective in closure of refractory lymphatic fistulas. We present a case of refractory chylous ascites following radical nephrectomy with inferior vena caval thrombectomy that failed to respond to conventional conservative measures and resolved rapidly following the administration of Somatostatin.
Leibovitch
Ilan
I
Department of Urology, The Chaim Sheba Medical Center, Tel Hashomer, Israel. ilanl1@isdn.net.il
Mor
Yoram
Y
Golomb
Jacob
J
Ramon
Jacob
J
D002915:Chylous Ascites / Q000188:drug therapy* / Q000209:etiology*; D005260:Female; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D009392:Nephrectomy; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology; D013004:Somatostatin / Q000627:therapeutic use*; D017131:Thrombectomy; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000601:surgery*
D006728:Hormones; D013004:Somatostatin