Chylous ascites following resection of a ruptured abdominal aneurysm. Treatment with a peritoneovenous shunt
W. G. Sarazin and K. E. Sauter
The development of chylous ascites after an abdominal surgical procedure is
potentially grave. It frequently leads to malnutrition and significant
mortality. Chylous ascites developed after emergency repair of a ruptured
abdominal aneurysm. In spite of treatments with low-fat diet (medium-chain
triglycerides), hyperalimentation, and abdominal paracentesis,
hypoproteinemia and peripheral edema developed and symptomatic ascites
continued. Though some success has been reported following ligation of
leaking lymphatics, we avoided laparotomy because the patient was
recovering from formidable complications. A peritoneovenous shunt was
placed. No complications occurred and permanent recovery promptly resulted.
We believe this is a reasonable alternative to laparotomy.
