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Chylous ascites following radical nephrectomy: a case report
Shahzad S Shah1, Kamran Ahmed, Richard Smith
1Department of Urology, Guy's Hospital, Guy's & St Thomas' NHS Foundation Trust & GKT School of Medicine, London, UK. shahzad.shah@gstt.nhs.uk
Introduction:
Chylous ascites may result from diverse pathologies. Ascites results either due to blockage of the lymphatics or leak secondary to inadvertent trauma during surgery.
Case Presentation:
We report the first case of chylous ascites following radical nephrectomy for a renal cell carcinoma involving the right half of a crossed fused renal ectopia. The patient was managed conservatively.
Conclusion:
Post-operative chylous ascites is a rare complication of retroperitoneal and mediastinal surgery. Most cases resolve with conservative treatment which aims at decreasing lymph production and optimizing nutritional requirements along with palliative measures. Refractory cases need either open or laparoscopic ligation of the leaking lymphatic channels. A review of the current literature on the management of post-operative chylous ascites is presented.
