Postoperative chylous ascites

Chylous ascites after nephrectomy without lymphadenectomy for malignant rhabdoid tumor of the kidney: A rare occurrence and literature review

Chylous ascites (CA) is an extremely rare complication of abdominal surgery in children. This report describes a 4-month-old girl with malignant rhabdoid tumor of the kidney (MRTK), who developed CA after left nephrectomy without lymphadenectomy, and who was successfully treated conservatively with enteral therapy. The literature on CA after nephrectomy without lymphadenectomy for MRTK is reviewed herein, and the clinical problems of postoperative CA are discussed.

Lymphatic ascites following lymphadenectomy for gynecological malignancy

Seven patients seen between January 1995 and December 1998 developed symptomatic lymphatic ascites following either pelvic or para-aortic lymph node dissection. The incidence of symptomatic lymphatic ascites during this 4-year period was 2.7% (7 of 263 cases). The accumulation of ascites postoperatively was associated with a prolonged postoperative ileus, abdominal pain, and extended postoperative hospitalization. Once the condition was recognized, abdominal paracentesis resulted in rapid improvement of symptoms in two patients but repeated paracenteses were required for a further two patients who had significant complications as a result of these procedures. Two patients improved following spontaneous drainage of a large amount of ascites per vagina and did not require further intervention. The final patient settled with observation only. This condition can be difficult to recognize and is a potential cause of significant postoperative morbidity.

Treatment of chyloperitoneum after extended lymphatic dissection during duodenopancreatectomy

BACKGROUND

Chyloperitoneum is a rare postoperative complication that might be caused by an interruption of chylous ducts in the mesenteric root or the cysterna chyli. Two cases of chyloperitoneum after duodenopancreatectomy are reported in the literature.

METHODS

We here report the third case that developed a chyloperitoneum 2 wk postoperatively when he resumed his normal diet.

RESULTS

The patient was treated conservatively with paracenteses and chyloperitoneum subsided thereafter.

CONCLUSIONS

Chyloperitoneum after extended duodenopancreatectomy might be treated conservatively.