Rare case of concurrent severe chylous ascites after radical surgery for cervical cancer

Cervical cancer case supervened with chylous ascites after extensive hysterectomy is rarely reported, and is very difficult to deal with.

A 40-year-old female patient complained of a small amount of vaginal bleeding after intercourse over the past seven years, and then was diagnosed as cervical squamous cell carcinoma IIa, with moderate anemia and leucopenia. The patient underwent radiotherapy and was given leucogen and iron dextran to elevate blood leukocyte at the same time. Considering blood routine examination was normal, the patient underwent extensive hysterectomy, bilateral adenectomy, and pelvic lymphadenectomy. By day 30 postoperatively, chyluria test showed positive which indicated chylous ascites in the patient. Since then, the patient successively had hypoproteinemia, electrolyte imbalance, high fever, fungal infection, etc. Very fortunately, the patient made a remarkable recovery from the serious condition after a series of flexible anti-infection and effective supportive treatments.

Chylous ascites leads to the loss of lipid, plasma protein, fat-soluble vitamins, and subsequently malnutrition. Firstly, the primary disease should be dealt with through chemotherapy or radiotherapy for malignant tumors. Anti-infective therapy can prevent intra-abdominal infections and the occurrence of bacteremia. Considering postoperative treatments last longer in this case, the authors changed antibiotics several times to avoid drug resistance. However, the patient unfortunately had complication of fungal septicemia due to the serious condition, which should to be avoided next time. In addition, the balance of water, electrolyte, and acid-base is particularly important in the overall treatment.