Multidisciplinary management of chylous ascites following resection of a retroperitoneal, functional Paraganglioma

Abstract

Extra-adrenal, functional paraganglioma, if not medically controlled, requires early surgical resection. This can often be challenging when found in a retroperitoneal location, where resections are prone to lymphatic disruption and chyle leaks. Chylous ascites carry a significant risk of protein and caloric malnutrition, dehydration, and even mortality given the nutrient-rich characteristic of lost lymphatic fluid. Dietary modification involving minimal fat intake is often frontline conservative treatment, however, prolonged, heavy-volume chylous ascites will require advanced medical and surgical intervention. This case illustrates the difficulties, complexities, and solutions with multidisciplinary management of lymphatic leakage following resection of a functional, retroperitoneal paraganglioma.

Keywords

• Chylous ascites
• Lymphangiography
• Nutrition
• Paraganglioma