1/48. Surgical management of chylous fistula after retroperitoneal lymph node dissection.Conservative treatment with low-fat diet, medium-chain triglyceride or total parenteral nutrition, depending on the general condition of the patient, is the mainstay in the treatment of chylous ascites. In patients with persistent chylous fistula direct surgical closure is a valid treatment option.- - - - - - - - - - ranking = 1keywords = nutrition (Clic here for more details about this article) |
2/48. Chylous complications after abdominal aortic surgery.Two patients developed chylous complications following abdominal aortic aneurysm repair. One patient had chylous ascitis and was successfully treated by a peritoneo-caval shunt. The other patient developed a lymph cyst, which gradually resorbed after puncture. Chylous complications following aortic surgery are rare. patients in bad a general condition should be treated by initial paracentesis and total parenteral nutrition, supplemented by medium-chain triglyceride and low-fat diet. If no improvement is observed on this regimen, the next step should be implementation of a peritoneo-venous shunt, whereas direct ligation of the leak should be reserved for those who are not responding to this treatment.- - - - - - - - - - ranking = 1keywords = nutrition (Clic here for more details about this article) |
3/48. Chyloperitoneum: a rare complication after abdominal aortic aneurysm repair.We report a case of chylous ascites as a rare complication following elective aortic aneurysm repair in a 66-year-old male. After early development of this condition on the second postoperative day, relaparotomy was performed with ligation of fistulae as well as omentoplasty. After recurrence of chylous ascites, conservative treatment consisting of parenteral nutrition and a low-fat diet for 3 months along with continuous peritoneal drainage finally led to successful resolution of this complication.- - - - - - - - - - ranking = 1keywords = nutrition (Clic here for more details about this article) |
4/48. chylous ascites: a rare complication of radical gastrectomy.chylous ascites is the accumulation of lymphatic fluid within the peritoneal cavity, due to trauma or obstruction to the lymphatic system. Postoperative chylous ascites is a rare complication of abdominal surgery. This is frequently reported after retroperitoneal dissections, and results in high morbidity and mortality. The treatment options are varied and include total parenteral nutrition (TPN), elemental diet with medium chain triglycerides (MCT), repeated paracentesis and surgical ligation. We report a case of post-operative chylous ascites after D2 distal gastrectomy. Treatment by fasting, TPN followed by fat-free diet resulted in complete resolution of ascites within 3 weeks. To our knowledge this is the first report of such a complication following radical gastrectomy. We review the literature and briefly discuss the management options.- - - - - - - - - - ranking = 1keywords = nutrition (Clic here for more details about this article) |
5/48. Chyloperitoneum. A rare complication after abdominal aortic aneurysm repair.We report a case of chylous ascites as a rare complication following elective aortic aneurysm repair in a 66-year-old male. After its early development on the second post-operative day, re-laparotomy was performed with ligation of fistulas and omentumplasty. After recurrence of chylous ascites, conservative treatment for three months including parenteral nutrition and low-fat diet under continuous peritoneal drainage led finally to success.- - - - - - - - - - ranking = 1keywords = nutrition (Clic here for more details about this article) |
6/48. octreotide therapy: a new horizon in treatment of iatrogenic chyloperitoneum.Chyloperitoneum is a rare and challenging complication of abdominal surgery. We report a case of iatrogenic chyloperitoneum. Infusion of octreotide, a somatostatin analogue, together with total parenteral nutrition followed by medium chain triglyceride diet resulted in rapid resolution of chyloperitoneum. We believe this to be the first report of successful use of octreotide in iatrogenic chyloperitoneum in a child.- - - - - - - - - - ranking = 1keywords = nutrition (Clic here for more details about this article) |
7/48. Successful surgical treatment of two cases of congenital chylous ascites.The authors report on 2 patients with congenital chylous ascites who underwent successful lymphatic duct ligation after a laparoscopic lymphoid dye test. Fetal ascites had been detected in both cases, and both babies were born with marked abdominal swelling. Given that conservative treatment by medium-chain triglyceride (MCT) milk and total parenteral nutrition (TPN) was ineffective, the authors elected to perform lymphatic duct ligation on the 95th postnatal day in the former case and on the 27th postnatal day in the latter case. Lipophilic dye was administered preoperatively both through oral and subcutaneous routes, and the peritoneal cavity was explored using laparoscopy. This laparoscopic lymphoid dye test precisely identified the area of chylous leakage, and the authors were able to repair the malformed lymphatic duct directly at laparotomy. Both postoperative courses have been favorable with no recurrence of symptoms. The lymphatic duct ligation should be considered in cases resistant to conservative treatment for over a month. The present laparoscopic lymphoid dye test is a novel and useful procedure that allows surgeons to identify the exact location of chylous leakage, and thus successfully ligate the lymphatic duct.- - - - - - - - - - ranking = 1keywords = nutrition (Clic here for more details about this article) |
8/48. Non-traumatic chylous effusion in the thorax and abdomen.A female of 31 with chyloascites and bilateral chylothorax is presented. The thoracic duct was obstructed below the diaphragm. The lymph vessels in the left iliac and para-aortic areas were enlarged and there were lymphocysts. When the lymph loss was greatest the patient was in a state of grave malnutrition with marked hypoalbuminaemia and an absolute and relative lymphocytopenia in the blood. "Malignant" cells were demonstrated in the chylous fluid, but no malignancy could be found at laparotomy. It is possible that the cells were confused with immature lymphocytes. The lymphatic cysts were excised and the lymph vessels ligated. Decortication of the right lung was performed. The patient recovered. The follow up time has been over four years.- - - - - - - - - - ranking = 1keywords = nutrition (Clic here for more details about this article) |
9/48. 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.- - - - - - - - - - ranking = 1keywords = nutrition (Clic here for more details about this article) |
10/48. Total parenteral nutrition as a primary therapeutic modality for congenital chylous ascites: report of one case.Congenital chylous ascites in the neonatal period is a rare entity. It is primarily related to congenital abnormalities of the lymphatics. We present a case in which ascites was detected by prenatal ultrasonogram. No evidence of congenital cytomegalovirus infection, intrauterine meconium peritonitis, or intestinal or genitourinary system abnormalities was found. Congenital chylous ascites was confirmed via an abdominal sonogram and diagnostic paracentesis. After 26 days of NPO and total parenteral nutrition, the newborn hadfully recovered.- - - - - - - - - - ranking = 5keywords = nutrition (Clic here for more details about this article) |
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