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Georgios Galanopoulos, Theofanis Konstantopoulos, Stavros Theodorou, Ioannis Tsoutsas, Dimitrios Xanthopoulos, Elias Kaperonis, Vassilios Papavassiliou
Chylous ascites is a rare complication after abdominal aortic aneurysm repair. Accumulation of chyle within the close space of the peritoneal cavity may cause severe discomfort to the patient, complicating the postoperative course. Prompt diagnosis is needed to adopt measures for reducing lymph leakage and contributing to lymphatic fistula closure. Fortunately, conservative treatment is successful in the majority of cases. In the rare cases that do not respond to conservative treatment, surgery becomes mandatory...
April 2016: Methodist DeBakey Cardiovascular Journal
Megan Jagosky, Brice Taylor, Stephanie Parks Taylor
Chyloperitoneum, or chylous ascites, is a rare condition characterized by milky-appearing fluid with elevated triglyceride content and the presence of chylomicrons. Malignancy, specifically lymphoma, is reported to be the predominant cause in Western countries. Previously, the prognosis for patients with chyloperitoneum due to lymphoma has been reported as poor. We present a case of chyloperitoneum and chylothorax due to follicular lymphoma with excellent response to bendamustine and Rituxan. A review of the literature indicates that patients with chyloperitoneum associated with lymphoma generally have a favorable response to contemporary treatment regimens...
2016: Case Reports in Hematology
Sami Alasari, Min Sung Kim, Seung Hyuk Baik, Byung Soh Min, Nam Kyu Kim
Aim. To prove the safety and feasibility of minimally invasive (laparoscopic and robotic) colorectal resection in kidney recipients by evaluating the technical protocol and reviewing short- and long-term outcomes. Methods. Between May 2007 and August 2012, a retrospective review of ten kidney transplant patients diagnosed with colorectal cancer was evaluated for technical tips, short- and long-term outcomes. Results. The mean patients' age was 56.8 ± 9.91 years and 50% of them were male. Anterior and low anterior resections were performed in 40% of the patients each; 20% and 10% of the patients underwent right and left hemicolectomy, respectively...
2014: International Scholarly Research Notices
Joaquín Pérez, José María Arribas, Enrique Cárdenas, Francisco Gutiérrez, Rubén Taboada, Norberto Cassinello
Chyloperitoneum is a rare but life-threatening complication with no uniformity concerning the treatment. We present a 77-year-old male with chylous ascites after open abdominal aneurysmectomy refractory to conservative and surgical strategies. After failure of re-exploration with periaortic lymphatic cauterization and drainage, he was treated with five cycles of retroperitoneal radiotherapy. At 12 months of follow-up, the patient remains asymptomatic without any objective evidence of chyloperitoneum relapse...
October 2013: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Elżbieta Radzikowska
Lymphangioleiomyomatosis (LAM) is a rare multisystem disease, occurs in women, usually premenopausal, caused by the proliferation of neoplastic smooth muscle-derived cells. Mutations in the tuberous sclerosis complex genes, lead to the activation of mammalian target of rapamycin kinase (mTOR), results in proliferation of LAM cells, its increasing motility, and survival. Polycystic lung destruction, extensive involvement of lymphatic channels, chylothorax, chyloperitoneum, and renal angiomyolipomas can develop in LAM patients...
August 2015: Lung
Dae-Weung Kim, Myoung Hyoun Kim, Chang Guhn Kim
A 74-year-old woman underwent the radical near-total gastrectomy with Billroth II anastomosis and lymph nodes dissection due to the advanced gastric cancer. On the seventh day after gastrectomy, edema on the both legs and abdominal distention were developed. On the lymphoscintigraphy, the abnormal activity in the peritoneal cavity was revealed, and chyloperitoneum was diagnosed, and additional dynamic scans could localize the chyle leakage focus. Localization of chyle leakage focus enabled surgeon to establish the proper operative plan for the injured lymphatics...
January 2015: Clinical Nuclear Medicine
Mohsen Sokouti, Babak Abri Aghdam
A 15- year-old boy was referred to Imam Reza Hospital with a right chest tube and chylothorax for 40 days. The patient had respiratory distress and undergone refractory treatment for chylothorax. The fluid content was chyle-rich in lipids. Computed Tomography of the chest showed a large, incompletely evacuated cyst in the left posterior mediastinum with left pleural effusion. The cyst could not be resected through right thoracotomy, because of the left side location of the cyst. Ligation of the thoracic duct through right thoracotomy was not effective in reducing chylous effusion 4 days later...
2011: Tanaffos
Julie Veziant, Laurent Sakka, Géraud Galvaing, Marie M Tardy, Lucie Cassagnes, Marc Filaire
Thoracic duct (TD) cyst is an uncommon abnormality that can be manifested as a cervical swelling. Pathogenesis includes congenital or degenerative weakness of the wall of the TD and obstruction of the lymphoid flow. Diagnosis is crucial to eliminate malignant disease or vein thrombosis and can be established by imaging and needle aspiration. We report a case of recurrent cervical swelling with spontaneous chylothorax and chyloperitoneum. A TD cyst with a terminal obstruction of the TD was diagnosed on lymphangiography...
October 2015: Journal of Vascular Surgery
Jui-Hsiang Lin, Wei-Jie Wang
Chyloperitoneum associated with nephrotic syndrome is rare clinical entity and characterized by milky ascites. The modalities for detection of chyloperitoneum are laboratory investigations and radiological images. Lipoprotein electrophoresis is useful for confirmation of the diagnosis with chyloperitoneum. Treating underlying disease is the most important in the management of these patients.
2012: Case Reports in Nephrology
Chwanrow Karim Baban, Michael Murphy, Cristóir O'Sulleabháin, Deirdre O'Hanlon
Chylous ascites (chyloperitoneum) is a rare clinical condition, characterized by an accumulation of lymph fluid in the peritoneal cavity. Most commonly it is associated with abdominal malignancy (usually lymphoma). We present an unusual case of a woman who developed a persistent pseudocyst and recurrent chylous ascites following acute necrotizing pancreatitis.
2014: BMJ Case Reports
Aisling L Snow, Wibke Uller, Hueng Bae Kim, Ahmad I Alomari
Postoperative chylous leak may result from thoracic duct injury during surgical procedures in the chest or neck and can be successfully treated with percutaneous embolization. We report the case of a child with persistent chylothorax and chyloperitoneum following multivisceral transplantation, which was performed due to unresectable inflammatory myofibroblastic tumor of the retroperitoneum. Intranodal lymphangiography was used to demonstrate the site of chylous leak from the lower segment of the thoracic duct and the leak resolved within days following percutaneous embolization of the thoracic duct...
August 2014: Cardiovascular and Interventional Radiology
Atsushi Nishimura, Mikako Kawahara, Keisuke Honda, Takahiro Ootani, Tomoyuki Kakuta, Chie Kitami, Shigeto Makino, Yasuyuki Kawachi, Keiya Nikkuni
BACKGROUND: Natural orifice specimen extraction (NOSE) has been developed as a means of decreasing the incidence of surgical wound complications. However, NOSE performed using a conventional multiport technique has been reported previously. The current authors performed totally laparoscopic anterior resection with transvaginal specimen extraction (TVSE) using the reduced-port surgery (RPS) technique. The Alexis wound retractor (Applied Medical, Rancho Santa Margarita, CA, USA) and Free Access (Top Corporation, Tokyo, Japan) were attached to the transvaginal route for transvaginal assistance and smooth specimen extraction...
December 2013: Surgical Endoscopy
Marjan Joudi, Daryoush Hamidi Alamdari, Hamid-Reza Rahimi
BACKGROUND: Congenital chyloperitoneum is an uncommon clinical condition. A few cases of congenital chyloperitoneum in children have been described who were treated in a variety of methods. CASE PRESENTATION: Congenital chyloperito was diagnosed in a 5-day-old baby boy with a significant abdominal distension. Due to the failed conservative managements by medium-chain triglycerides (MCT) enriched milk and partial parenteral nutrition (PPN), the authors tried platelet rich fibrin glue (PRFG) as an alternative choice which was applied through an already inserted intra-abdominal catheter...
June 2013: Iranian Journal of Pediatrics
Juan C Lopez-Gutierrez, Miriam Miguel, Mercedes Diaz, Zoraida Ros, Juan A Tovar
BACKGROUND: Progressive osteolysis caused by lympathic malformations is a rare condition that should be known by specialists involved in the study of lymphatic disorders because they are necessarily involved in the treatment. The purpose of the present study is to report on a large series of patients to illustrate the multiple clinical pictures and the wide range of therapeutic measures necessary for arresting bone destruction and lymphatic leak. METHODS AND RESULTS: Inclusion criteria were osteolysis associated with lymphatic malformation that required treatment...
December 2012: Lymphatic Research and Biology
A Chachaj, K Drozdz, M Chabowski, P Dziegiel, I Grzegorek, A Wojnar, P Jazwiec, A Szuba
Lymphangioleiomyomatosis (LAM) is a rare disease characterized by diffuse thin-walled cysts throughout the lungs on computed tomography and diffuse proliferation of abnormal smooth muscle-like cells (LAM cells) on lung biopsy. LAM affects women almost exclusively, predominantly in their reproductive age. The most typical presenting symptoms include dyspnea, spontaneous pneumothorax, cough and chylothorax. Abdominal findings represent less common initial manifestations of the disease and may pose diagnostic difficulties...
June 2012: Lymphology
Saziye Karaca, Gino Gemayel, Afksendiyos Kalangos
Chyloperitoneum is an uncommon but serious complication of abdominal aortic surgery. There are no optimal guidelines for the management of chyloperitoneum. We present here our experiences regarding the treatment of chyloperitoneum with somatostatin for three patients who underwent surgery for abdominal aortic disease. Milky, odorless liquid was observed in the abdominal drain of these patients. The conservative treatment with total parenteral nutrition failed; therefore, in parallel, we initiated a somatostatin treatment as a continuous perfusion...
November 2012: Journal of Vascular Surgery
Eng-Kian Ling, Bing-Shi Lin, Shou-Shan Chiang, Ming-Hsien Tsai
The discoloration of effluent peritoneal dialysate, which is transparent in origin, is seen in some particular conditions including chyloperitoneum, calcium channel blocker usage, hemoperitoneum, perforated cholecystitis, iron administration, and hemorrhagic pancreatitis. We report a case of a 60-year-old woman who underwent peritoneal dialysis for 3 years and presented with conspicuous cola-colored (brownish-black) dialysate after a cardiac surgery. The findings of the dialysate analysis and the abdominal computed tomography showed that this discoloration could be due to the presence of methemalbumin caused by pancreatitis (not hemorrhagic) combined with intra-abdominal bleeding-both of which are rare gastrointestinal complications of cardiac surgery...
2012: Renal Failure
Gakuryu Nakayama, Daisuke Morioka, Takashi Murakami, Hideki Takakura, Yasuhiko Miura, Shinji Togo
Chylous ascites occurring after abdominal surgery is rare. Despite being potentially critical, there is no definite treatment guideline because of its rarity. Here we present a case of massive chylous ascites occurring after rectal surgery which was successfully treated with an oral fat-free elemental diet (ED). A 67-year-old man underwent low anterior resection with para-aortic lymphadenectomy for advanced rectal cancer. Early postoperative course was uneventful and the patient was discharged from hospital 10 days after surgery; however, after discharge, abdominal distension rapidly developed...
June 2012: Clinical Journal of Gastroenterology
Inas Babic, Maha Tulbah, Samir Ghourab
INTRODUCTION: Chyloascites or chyloperitoneum, which can be caused by different factors, is a process of eruption of one or many lymphatic vessels spontaneously. Malignant processes, inflammation or trauma can cause a sudden burst in a lymphatic vessel which will lead to a collection of milky fluid in any space of the human body with the abdominal cavity being the most common location. Chyloperitoneum is rare during pregnancy and this case is the fifth described worldwide. CASE PRESENTATION: We describe a case of chyloascitis in a 27-year-old primigravida Middle Eastern woman, found coincidentally during cesarean section...
2012: Journal of Medical Case Reports
Georgios K Georgiou, Haralampos Harissis, Michalis Mitsis, Haralampos Batsis, Michalis Fatouros
We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse. The development of chylous ascites is usually a chronic process mostly involving malignancy, trauma or surgery, and symptoms arise as a result of progressive abdominal distention. However, when accumulation of "chyle" occurs rapidly, the patient may present with signs of peritonitis. Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation, appendicitis or visceral ischemia...
April 28, 2012: World Journal of Gastroenterology: WJG
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