Related Experiment Videos
Chyloretroperitoneum with secondary chylothorax after retroperitoneoscopic donor nephrectomy
Alexander Bachmann1, Robin Ruszat, Michael Dickenmann
1Department of Urology, University of Basel, Basel, Switzerland.
Urology
|October 19, 2005
Summary
Managing severe chylous fistula after living donor nephrectomy is challenging. Early maximal conservative therapy is recommended, with surgery reserved for pain or mechanical issues.
Area of Science:
- Nephrology
- Surgical Oncology
- Gastroenterology
Background:
- Living donor nephrectomy is a common procedure.
- Complications can arise post-surgery, impacting patient recovery.
- Chylous fistula is a rare but serious complication.
Observation:
- A 59-year-old woman developed abdominal pain and diarrhea post-nephrectomy.
- Computed tomography identified chyloretroperitoneum, requiring drainage.
- The patient later developed chylothorax, necessitating thoracic drainage and parenteral therapy.
Findings:
- Conservative management with dietary changes (short-chain and medium-chain fatty acids) was unsuccessful.
- Somatostatin therapy was ultimately administered.
- Postoperative management of severe chylous fistula presents significant difficulties.
Implications:
- Early and aggressive conservative management is crucial for chylous fistula.
- Surgical intervention should be considered based on pain and mechanical complications.
- This case highlights the complexity of managing chylous fistulas in kidney transplant donors.