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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


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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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