title: Chylous ascites after pedicled transverse rectus abdominis myocutaneous flap harvest.
abstract: Chylous ascites is a rare clinical condition that occurs as a consequence of disruption of the abdominal lymphatics. Here, we present the case of a 58-year-old woman with sustained chylous ascites after pedicled transverse rectus abdominis myocutaneous (TRAM) flap harvest. The chylous ascites did not decrease despite conservative therapy. For the diagnosis and localization of the chyle leakage, lymphangiography with lipiodol delivery was performed. Chylous drainage continued in a decreasing manner for the next 4 d because lipiodol accumulated to the point of leakage outside the lymphatic vessel causing a regional inflammatory reaction and obstructing the lymphatic vessels. To our knowledge, there is no case of chylous ascites related to pedicled TRAM flap harvest that has been reported in the English literature, in which the chyle leakage spontaneously resolved after lymphangiography.
authors.affiliation: a Division of Plastic and Reconstructive Surgery, Department of Surgery , Tri-Service General Hospital, Taipei, Taiwan; National Defense Medical Center , Taipei , Taiwan.
authors.forename: Chin-Ta
authors.initials: CT
authors.lastname: Lin
authors.affiliation: a Division of Plastic and Reconstructive Surgery, Department of Surgery , Tri-Service General Hospital, Taipei, Taiwan; National Defense Medical Center , Taipei , Taiwan.
authors.forename: Tim-Mo
authors.initials: TM
authors.lastname: Chen
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000601:surgery*; D002915:Chylous Ascites / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects* / Q000379:methods; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D064827:Myocutaneous Flap / Q000009:adverse effects*; D010529:Peritoneal Cavity; D035583:Rare Diseases; D017568:Rectus Abdominis / Q000601:surgery*; D018570:Risk Assessment; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome
keywords: Breast cancer; chylous ascites; complication; pedicled transverse rectus abdominis myocutaneous flap; reconstruction