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A Journal on Surgery

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Chirurgia 2009 August;22(4):207-9

language: English

Resolution of a postoperative chylous ascites using octreotide therapy. Case report and literature review

Legnani G. 1, Rasini M. 1, Pastori S. 1, Sarli D. 1, Rebuffat C. 2

1 General Surgery Unit, Policlinico San Pietro, Ponte San Pietro, Bergamo, Italy
2 Unit of General Surgery, University of Milan, Milan, Italy


Chylous ascites or chyloperitoneum represents the accumulation of chyle in the peritoneal cavity. Tumors, infections, cirrhosis and congenital lymphatic abnormalities are the most important etiologic factors. Postoperative chyloperitoneum is a rare complication of intra or retroperitoneal pediatric surgery, after the establishment of a lymphoperitoneal fistula due to lymphatic vessels section. Its management is not well established and the treatment should be individualized, with 2/3 of the patients responding to conservative therapy in absence of malignancies or congenital disease. Surgical treatment is reserved after unsuccessful conservative management. Herein is reported the case of a postoperative chyloperitoneum in a 17 year old girl after videolaparoscopic appendectomy together with mesenteric lymphnode biopsy, successfully treated with fasting, total parenteral nutrition (TPN) and somatostatin analogue i.v. infusion.

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