February 1986

Chylous Ascites Following Resection of a Ruptured Abdominal AneurysmTreatment With a Peritoneovenous Shunt

Author Affiliations

From the Department of Surgery, St Joseph's Hospital (Drs Sarazin and Sauter), and the Medical College of Wisconsin, Milwaukee (Dr Sauter). Dr Sarazin is now in private practice in Houghton, Mich.

Arch Surg. 1986;121(2):246-247. doi:10.1001/archsurg.1986.01400020132019

• The development of chylous ascites after an abdominal surgical procedure is potentially grave. It frequently leads to malnutrition and significant mortality. Chylous ascites developed after emergency repair of a ruptured abdominal aneurysm. In spite of treatments with low-fat diet (medium-chain triglycerides), hyperalimentation, and abdominal paracentesis, hypoproteinemia and peripheral edema developed and symptomatic ascites continued. Though some success has been reported following ligation of leaking lymphatics, we avoided laparotomy because the patient was recovering from formidable complications. A peritoneovenous shunt was placed. No complications occurred and permanent recovery promptly resulted. We believe this is a reasonable alternative to laparotomy.

(Arch Surg 1986;121:246-247)