title: Chyloretroperitoneum with secondary chylothorax after retroperitoneoscopic donor nephrectomy.
abstract: A 59-year-old woman complained of increasing pain in the left abdomen and of diarrheal symptoms after left-sided retroperitoneoscopic living donor nephrectomy. Computed tomography revealed chyloretroperitoneum. The fluid was drained percutaneously, followed by recurrent drain replacement surgery. Her diet was changed to short-chain and medium-chain fatty acids without success. After onset of dyspnea due to chylothorax, the donor underwent thoracic drainage, fully parenteral therapy, and finally somatostatin application therapy. The postoperative management of severe chylous fistula is difficult. Therefore, we recommend an early start of maximal conservative therapy. Surgical options depend on pain occurrence or mechanical problems.
authors.affiliation: Department of Urology, University of Basel, Basel, Switzerland.
authors.forename: Alexander
authors.initials: A
authors.lastname: Bachmann
authors.forename: Robin
authors.initials: R
authors.lastname: Ruszat
authors.forename: Michael
authors.initials: M
authors.lastname: Dickenmann
authors.forename: Olivier
authors.initials: O
authors.lastname: Giannini
authors.forename: Michael
authors.initials: M
authors.lastname: Mayr
authors.forename: Jürg
authors.initials: J
authors.lastname: Steiger
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Gasser
authors.forename: Tullio
authors.initials: T
authors.lastname: Sulser
mesh_terms: D002916:Chylothorax / Q000209:etiology* / Q000628:therapy; D002915:Chylous Ascites / Q000150:complications / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D019520:Living Donors; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D012187:Retroperitoneal Space; D014019:Tissue Donors