[Chylous ascites: a rare and awesome complication of aortic surgery]

Chylous ascites is a rare complication in abdominal aortic surgery, there have been thirteen previously reported cases of chylous ascites after aortic surgery, both for aneurysmectomy or revascularization. This complication always represents a difficult problem in patient management because of the serious failures of the nutritional balance, the potentially dangerous immunological deficit and the frequent respiratory function impairment overcoming with various mechanisms. Analysis of ascitic liquid, which shows the aspect and chemical composition of chyle, is required to make the diagnosis. Several therapeutic pathways are possible for the treatment of this complication (paracentesis, reinfusion of chyle, diuretics, total parenteral hyperalimentation, medium-chain triglyceride diet, peritoneovenous shunt, operative closure) and the choice results in an association which is specific for each patient. This article describes a further case of postoperative chylous ascites after aortic surgery and envisages the main lines of the treatment of this iatrogenic pathology.