Conservative management of large-volume chylous ascites following a robotic-assisted left radical nephrectomy

Chyle leak is a rare complication following nephrectomy and may result in chylous ascites. A patient in her 70s was diagnosed with a left renal tumour and underwent a robotic-assisted radical nephrectomy. She presented 9 days post discharge with chyle leaking from the left port site wound, which settled after 2 days of inpatient monitoring. 17 days later, she re-presented with significant abdominal distension and was diagnosed with large-volume chylous ascites. An abdominal drain was inserted, and she was started on 50µg octreotide two times per day and discharged. She was then readmitted 7 days later with dizziness, hyponatraemia and significant weight loss, and treated with total parenteral nutrition for 29 days. Her drain output declined gradually, and the ascites did not reaccumulate after it was eventually removed. This case highlights a rare instance of large-volume chylous ascites following robotic-assisted radical nephrectomy, and how it may be successfully treated using conservative methods.