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Management of Refractory Chylous Ascites
Keir Mailley1, Ana Maria Tortajada-Roman1, Mohammed Aly1
1Dept. of Urology, QEUH, 1345 Govan Rd, Glasgow, G51 4TF, UK.
Urology Case Reports
|July 31, 2025
Summary
Retroperitoneal lymph node dissection can lead to chylous ascites. CT-guided lymphatic embolization effectively treated this complication when conservative measures failed.
Area of Science:
- Urology
- Interventional Radiology
- Gastroenterology
Background:
- Retroperitoneal lymph node dissection (RPLND) is a key procedure for staging and treating certain cancers.
- Post-RPLND complications, such as chylous ascites, can be challenging to manage.
- Accurate diagnosis and effective treatment are crucial for patient outcomes.
Observation:
- A patient developed chylous ascites after undergoing RPLND for a PET-positive lymph node.
- Initial conservative treatments including dietary changes, parenteral nutrition, and drainage were unsuccessful.
- Recurrence of chylous ascites was noted after trans-nodal lymphangiography with lipiodol.
Findings:
- CT-guided percutaneous lymphatic embolization using NBCA glue and lipiodol was performed.
- This interventional procedure successfully resolved the chylous ascites.
- The patient experienced a successful outcome and was discharged.
Implications:
- CT-guided lymphatic embolization offers a definitive treatment option for refractory chylous ascites post-RPLND.
- This technique provides a minimally invasive approach to managing lymphatic leaks.
- Further research may explore the long-term efficacy and safety of this embolization technique.
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