Biomaterial Database

Chylous ascites complicating elective abdominal aortic aneurysm repair: case report and review of treatment options. 2012

Hashem M Barakat, and Yousef Shahin, and Peter McCollum

Academic Vascular Surgical Unit, Hull York Medical School, University of Hull, Hull, United Kingdom. hashem.barakat@gmail.com

BACKGROUND Chylous ascitis is a rare complication of abdominal aortic aneurysm (AAA) surgery with only 38 cases reported since the early 70s. Due to their anatomical relation with the abdominal aorta, cisterna chyli injury is more common following open AAA repairs when compared to other surgeries; 81% of all postsurgical chylous ascites reported. METHODS We present a case of severe chylous ascitis following elective AAA repair in a 76-year-old caucasian male who gradually developed abdominal distension following discharge. A conservative approach was followed by a peritoneovenous shunt insertion, but this had no clinical benefit. The site of chyle leak was identified and ligated at relaparatomy to eventually resolve his ascitis. CONCLUSIONS Many reports in literature demonstrate successful conservative measures and highlight the importance of nutritional status in the course of persistent postoperative chylous ascitis. In our experience, complete resolution only came after relaparatomy and repair of leaking lymphatics.

UI	MeSH Term	Description	Entries
D008026	Ligation	Application of a ligature to tie a vessel or strangulate a part.	Ligature,Ligations,Ligatures
D008297	Male		Males
D010289	Parenteral Nutrition, Total	The delivery of nutrients for assimilation and utilization by a patient whose sole source of nutrients is via solutions administered intravenously, subcutaneously, or by some other non-alimentary route. The basic components of TPN solutions are protein hydrolysates or free amino acid mixtures, monosaccharides, and electrolytes. Components are selected for their ability to reverse catabolism, promote anabolism, and build structural proteins.	Hyperalimentation, Parenteral,Intravenous Hyperalimentation,Nutrition, Total Parenteral,Parenteral Hyperalimentation,Total Parenteral Nutrition,Hyperalimentation, Intravenous
D010536	Peritoneovenous Shunt	An operation for the continuous emptying of ascitic fluid into the venous system. Fluid removal is based on intraperitoneal and intrathoracic superior vena cava pressure differentials and is performed via a pressure-sensitive one-way valve connected to a tube traversing the subcutaneous tissue of the chest wall to the neck where it enters the internal jugular vein and terminates in the superior vena cava. It is used in the treatment of intractable ascites.	Ascites Shunt, Peritoneovenous,LeVeen Shunt,Peritoneo-Venous Shunt,Ascites Shunts, Peritoneovenous,Peritoneo Venous Shunt,Peritoneo-Venous Shunts,Peritoneovenous Ascites Shunt,Peritoneovenous Ascites Shunts,Peritoneovenous Shunts,Shunt, LeVeen,Shunt, Peritoneo-Venous,Shunt, Peritoneovenous,Shunt, Peritoneovenous Ascites,Shunts, Peritoneo-Venous,Shunts, Peritoneovenous,Shunts, Peritoneovenous Ascites
D012086	Reoperation	A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery.	Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D002915	Chylous Ascites	Presence of milky lymph (CHYLE) in the PERITONEAL CAVITY, with or without infection.	Ascites, Chylous,Chyloperitoneum,Chylous Peritonitis,Peritonitis, Chylous
D003131	Combined Modality Therapy	The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used.	Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D004322	Drainage	The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.
D005765	Gastrointestinal Agents	Drugs used for their effects on the gastrointestinal system, as to control gastric acidity, regulate gastrointestinal motility and water flow, and improve digestion.	Digestants,Gastric Agents,Gastric Drugs,Gastrointestinal Drugs,Agents, Gastric,Agents, Gastrointestinal,Drugs, Gastric,Drugs, Gastrointestinal
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man