Therapeutic lymphangiography for refractory post-operative chylous ascites in children: Can a needle replace the knife?

Abstract

Chylous ascites is a rare but well-known complication following surgeries involving extensive dissection of the retroperitoneal structures. It is noticed in children primarily after oncological resections. Meanwhile, conservative treatment is paramount in its management; refractory cases generally require an aggressive approach. A rare case of refractory chylous ascites in a two-year-old boy occurring after excision of recurrent retroperitoneal neuroblastoma is being reported. The child underwent therapeutic lymphangiography with ethiodized oil, as an alternative to surgery, to tackle the refractory post-operative chyle leak. A prompt response was noticed and no recurrence of ascites has been observed during a 15-month follow-up.

Keywords

• Chylous ascites
• Refractory
• Children
• Retroperitoneal neuroblastoma
• Therapeutic lymphangiography