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chylous ascites

Markus A Thaler, Andreas Bietenbeck, Christoph Schulz, Peter B Luppa
OBJECTIVES: Lipoprotein electrophoresis is the gold standard for the detection of chylous ascites and pleural effusions. It is, however, not suitable as a front-line test and not widely available. Most clinicians must rely solely on the quantitative determination of lipids. The aim of this work was to establish lipid cut-off values for the presence of chylomicrons in pleural and peritoneal fluid. DESIGN AND METHODS: Triglyceride and cholesterol levels from 113 peritoneal and 154 pleural fluid samples investigated for chylomicrons via lipoprotein electrophoresis were considered...
October 14, 2016: Clinical Biochemistry
Heather Miller, Matthew L Anderson, Christopher P Smith, Alireza A Shamshirsaz, Karin A Fox
BACKGROUND: Chylous ascites is defined as the pathologic accumulation of lymphatic fluid within the peritoneal cavity and has been reported to complicate gynecologic surgeries, with an incidence of 0.17-2%. We report a case of chylous ascites after complex surgery for placenta percreta. CASE: A 26-year-old woman underwent cesarean delivery followed by bilateral uterine artery embolization and modified radical hysterectomy at 26 5/7 weeks of gestation for placenta percreta invading the urinary bladder...
October 6, 2016: Obstetrics and Gynecology
Gaurav Pahouja, Kalpit Patel, Daniel J Ricchiuti
OBJECTIVE: The aim of the study was to present a case series of the sparsely reported complication of chylous ascites (CA) after left sided robot-assisted laparoscopic partial nephrectomy (RALPN), identify possible risk factors for the development of postoperative CA, and explore current recommendations for identification, management and prevention of CA. MATERIAL AND METHODS: A retrospective review of patients that were treated with a RALPN during a one year time period (August 2012 to August 2013) by one surgeon at our institution was conducted...
October 5, 2016: Archivio Italiano di Urologia, Andrologia
Marc G Besselink, L Bengt van Rijssen, Claudio Bassi, Christos Dervenis, Marco Montorsi, Mustapha Adham, Horacio J Asbun, Maximillian Bockhorn, Oliver Strobel, Markus W Büchler, Olivier R Busch, Richard M Charnley, Kevin C Conlon, Laureano Fernández-Cruz, Abe Fingerhut, Helmut Friess, Jakob R Izbicki, Keith D Lillemoe, John P Neoptolemos, Michael G Sarr, Shailesh V Shrikhande, Robert Sitarz, Charles M Vollmer, Charles J Yeo, Werner Hartwig, Christopher L Wolfgang, Dirk J Gouma
BACKGROUND: Recent literature suggests that chyle leak may complicate up to 10% of pancreatic resections. Treatment depends on its severity, which may include chylous ascites. No international consensus definition or grading system of chyle leak currently is available. METHODS: The International Study Group on Pancreatic Surgery, an international panel of pancreatic surgeons working in well-known, high-volume centers, reviewed the literature and worked together to establish a consensus on the definition and classification of chyle leak after pancreatic operation...
September 28, 2016: Surgery
Jenny M Held, Ryan Restrepo, Robert Ricca
No abstract text is available yet for this article.
September 2016: American Surgeon
Yudai Fukui, Junichi Shindoh, Shuichiro Matoba, Kenji Tomizawa, Yutaka Hanaoka, Shigeo Toda, Jin Moriyama, Hiroya Kuroyanagi
A 53-year-old man was readmitted with abdominal distention 2 weeks after undergoing laparoscopic low anterior resection with para-aortic lymphadenectomy for advanced rectal cancer (T4aN1M0, Stage IIIb). Ultrasound revealed massive ascites, and paracentesis revealed chylous fluid with a markedly elevated triglyceride level (1762 mg/dL). Despite conservative management, the fistula remained on postoperative day 120. On percutaneous lymphangiography, the chylous leakage point was clearly visualized at the para-aortic site, and surgical intervention was planned...
September 26, 2016: Asian Journal of Endoscopic Surgery
Soo Young Lee, Chang Hyun Kim, Young Jin Kim, Hyeong Rok Kim
PURPOSE: Data on the incidence, risk factors, and oncologic impact of chylous ascites after colorectal cancer surgery are scarce. In this study, we aimed to assess the risk factors and the short-term and long-term impact of chylous ascites after colorectal cancer surgery. METHODS: We retrospectively examined 2917 primary colorectal cancer patients who underwent surgical resection between January 2008 and December 2013. The short-term and long-term outcomes were compared between patients with and those without postoperative chylous ascites, and the risk factors for chylous ascites were analyzed...
August 24, 2016: Langenbeck's Archives of Surgery
Chin-Ta Lin, Tim-Mo Chen
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...
August 18, 2016: Acta Chirurgica Belgica
Sergio Harari, Davide Elia, Olga Torre, Elisabetta Bulgheroni, Elena Provasi, Joel Moss
A young woman received a diagnosis of abdominal, sporadic lymphangioleiomyomatosis (LAM) and multiple abdominal lymphangioleiomyomas and was referred for recurrent chylous ascites responding only to a fat-free diet. On admission, pulmonary function test (PFT) results showed a moderate reduction in the transfer factor for carbon monoxide with normal exercise performance. The serum vascular endothelial growth factor D (VEGF-D) level was 2,209 pg/mL. DNA sequences, amplified at loci kg8, D16S3395, D16S3024, D16S521, and D16S291 on chromosome 16p13...
August 2016: Chest
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
Yuichi Akama, Tetsuya Shimizu, Itsuo Fujita, Yoshikazu Kanazawa, Daisuke Kakinuma, Hitoshi Kanno, Aya Yamagishi, Hiroki Arai, Eiji Uchida
BACKGROUND: Chylous ascites is an uncommon finding which is usually associated with recent abdominal/oncologic or retroperitoneal surgery. It is not usually seen in cases of acute obstruction. CASE PRESENTATION: A patient who had previously undergone a laparoscopy-assisted distal gastrectomy with Roux-en-Y reconstruction for early gastric cancer presented with acute abdominal pain and epigastric fullness. Computed tomography suggested small bowel obstruction due to volvulus...
December 2016: Surgical Case Reports
A R Patil, S Nandikoor, J De Marco, R Bhat, S Shivakumar, G Mallrajapatna
The lymphatic system of the abdomen comprises of the cisterna chyli, its major and minor lymphatic tributaries, and lymph nodes. Disorders of the lymphatic system of the abdomen are rarely encountered and consist of primary and secondary types. Abdominal lymphangiomas constitute the majority and have characteristic imaging features. Complicated lymphangiomas may pose a diagnostic dilemma. Generalised systemic lymphangiomatosis is a rare condition and affects major organs with a poor prognosis. Retroperitoneal lymphangiectasia in the appropriate setting might predict underlying infection, such as filariasis...
October 2016: Clinical Radiology
Yi Cao, Weihui Yan, Lina Lu, Yijing Tao, Wei Lu, Yingwei Chen, Qingya Tang, Wei Cai
Congenital chylous ascites in the neonatal period is a rare entity. Total parenteral nutrition (TPN), medium chain triglyceride (MCT)-based diet, octreotide and repeated paracentesis are regarded as appropriate medical treatment for congenital chylous ascites, and surgery is recommended when conservative therapy has failed. We present two cases in which ascites were confirmed via an abdominal sonogram and diagnostic paracentesis. In our clinical experience, rice soup combined with PN can be a safe and effective intervention...
2016: Asia Pacific Journal of Clinical Nutrition
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
Flávia Fonseca Fernandes, Victor Oliveira Alves, Tarquino Erastides Gavilanes Sánchez, Wagner Diniz de Paula, Alfredo Nicodemos Cruz Santana
A previously healthy, 52-year-old woman presented with a nine months history of low fever and weight loss (> 30 kg). Physical examination disclosed generalized lymphadenopathy, skin lesions, abdominal distension, mild tachypnea and a left breast mass. Laboratory tests showed anemia; (prerenal) kidney injury, low serum albumin level; and negative serology for HIV and viral hepatitis. Computed tomography (neck/chest/abdomen) showed generalized lymph node enlargement, splenomegaly, pleural effusion and ascites...
July 11, 2016: Revista do Instituto de Medicina Tropical de São Paulo
Surinder Singh Rana, Puneet Chhabra, Vishal Sharma, Nadeem Pervez, Ravi Sharma, Radhika Srinivasan, Deepak Kumar Bhasin
No abstract text is available yet for this article.
May 2016: Endoscopic Ultrasound
Shiromani Janki, Türkan Terkivatan, Hendrikus J A N Kimenai, Jan N M IJzermans, T C Khé Tran
We present the first case report of chylous ascites following total robot-assisted donor nephrectomy. A 39-year-old female underwent a transperitoneal left-sided total robot-assisted donor nephrectomy. The procedure was uneventful and the patient was discharged without any symptoms. At postoperative Day 29, the patient presented with abdominal pain, nausea and a distended, painful abdomen with shifting dullness. She was diagnosed with chylous ascites by ultrasonography and puncture analysis, and treated with therapeutic drainage and dietary restriction...
2016: Journal of Surgical Case Reports
Falk C Thiel, Parnian Parvanta, Alexander Hein, Grit Mehlhorn, Michael P Lux, Stefan P Renner, Achim Preisner, Matthias W Beckmann, Michael G Schrauder
BACKGROUND AND OBJECTIVES: Chylous ascites, an accumulation of milky-white lymph fluid in the peritoneal cavity, is a rare complication following retroperitoneal lymphadenectomy. This study evaluated the appearance and management of chylous ascites following lymphadenectomy for gynecological malignancies. METHODS: A total of 931 patients who underwent lymphadenectomy for gynecological malignancies at Erlangen University Hospital between 2002 and 2013 were reviewed retrospectively...
October 2016: Journal of Surgical Oncology
Toshihiro Yasui, Tatsuya Suzuki, Fujio Hara, Shunsuke Watanabe, Naoko Uga, Atsuki Naoe, Tetsushi Yoshikawa, Tetsuya Ito, Yoko Nakajima, Hiroki Miura, Atsushi Sugioka, Yutaro Kato, Takamasa Tokoro, Yoshinao Tanahashi, Mureo Kasahara, Akinari Fukuda, Hiroki Kurahashi
MSUD is an autosomal recessive condition characterized by a deficiency in the enzyme, BCKDH, which catalyzes the breakdown of BCAAs. If left untreated, MSUD can result in mental retardation, central nervous system disorders, and even death. Most patients with MSUD are treated with a restricted protein diet and milk from which BCAAs have been removed. LT has been shown effective in patients with MSUD. This report describes the case of a 15-month-old boy who received a liver graft from his mother. Transplantation was successful, and the patient was then able to ingest a normal diet...
August 2016: Pediatric Transplantation
Enver Ilhan, Uygar Demir, Ali Alemdar, Orhan Ureyen, Yavuz Eryavuz, Mehmet Mihmanli
BACKGROUND: This study aimed to propose treatment strategies for high-output chylous ascites (CA) developed after gastric cancer surgery. METHODS: The data of patients with CA after gastric cancer surgery in three high volume Training and Research Hospitals between 2005 and 2015 were retrospectively evaluated. RESULTS: Nine patients out of 436 gastrectomies were detected with CA. The mean amount of daily fistula output was 939 mL. Treatment consisted of cessation of oral feeding, total parenteral nutrition (TPN), somatostatin analogs administration, clamping and/or removal of the drainage tube, diuretic administration and diet therapy with medium-chain triglycerides (MCTs) alone or in combination...
June 2016: Journal of Gastrointestinal Oncology
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