Chylous ascites as a complication of nephroureterectomy

Abstract

Chylous ascites may be the result of many pathological conditions, including congenital defects of the lymphatic system, nonspecific bacterial, parasitic and tuberculous peritoneal infection, liver cirrhosis, malignant neoplasm, blunt abdominal trauma, and surgical injury. A 62-year-old woman presented with chylous ascites after undergoing nephroureterectomy and bladder cuff excision for her left ureteral urothelial carcinoma. The diagnosis of chylous ascites is made when the ratio of ascitese versus serum triglyceride is > 2. Patients with chylous ascites may be treated conservatively with total parenteral nutrition and/or a diet containing low fat and medium chain triglycerides. Refractory cases may require more aggressive intervention. We report a case of postoperative chylous ascites that was treated successfully with total parenteral nutrition for 14 days. A review of the relevant literature is presented and chylous ascites treatment is also discussed.

Keywords

• chylous
• total parenteral nutrition
• urothelial carcinoma