Chylous Ascites: A Rare Complication of Liver Cirrhosis

1993 ◽  
Vol 13 (4) ◽  
pp. 372-374
Author(s):  
Shahid Barlas ◽  
Abdullah Hussain Awad ◽  
Khalid A. Khan ◽  
Mamoon Ur Rashid Safdar
Keyword(s):  
Liver Cirrhosis ◽  
Rare Complication ◽  
Chylous Ascites

scholarly journals A227 UMBILICAL HERNIA INCARCERATION IN LIVER CIRRHOSIS: A RARE COMPLICATION OF PARACENTESIS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 263-265
Author(s):  
A LAGROTTERIA ◽  
A Aruljothy ◽  
K Tsoi
Keyword(s):  
Liver Cirrhosis ◽  
Abdominal Pain ◽  
Case Report ◽  
Small Bowel ◽  
Large Volume ◽  
Umbilical Hernia ◽  
Rare Complication ◽  
Abdominal Wall Hernia ◽  
Refractory Ascites ◽  
Large Volume Paracentesis

Abstract Background Patients with decompensated liver cirrhosis with ascites frequently have umbilical hernias with a prevalence of 20% and are managed with large volume paracentesis (LVP). Common complications of LVP include hemorrhage, infection, and bowel perforation that occur infrequently with a frequency of less than 1%. However, incarceration of umbilical hernias has been reported as a rare complication of LVP and is speculated to be from ascitic fluid decompression that reduces the umbilical hernia ring diameter resulting in entrapment of the hernia sac. It is unclear whether the quantity or the fluid removal rate increases the herniation risk. Based on case series, this rare complication occurs within 48 hours of the LVP and requires emergent surgical repair and involves a high risk of morbidity and mortality due to potential infection, bleeding, and poor wound healing. Aims We describe a case report of an incarcerated umbilical hernia following a bedside large-volume paracentesis. Methods Case report Results A 59-year-old Caucasian male presented to the emergency department with a 24-hour history of acute abdominal pain following his outpatient LVP. His medical history included Child-Pugh class C alcoholic liver cirrhosis with refractory ascites managed with biweekly outpatient LVP and a reducible umbilical hernia. He reported the onset of his abdominal pain 2-hours after his LVP with an inability to reduce his umbilical hernia. Seven liters of clear, straw-coloured asitic fluid was drained. Laboratory values at presentation revealed a hemoglobin of 139 g/L, leukocyte count of 4.9 x109 /L, platelet count of 110 xo 109 /L, and a lactate of 2.7 mmol/L His physical exam demonstrated an irreducible 4 cm umbilical hernia and bulging flanks with a positive fluid wave test. Abdominal computed tomography showed a small bowel obstruction due to herniation of a proximal ileal loop into the anterior abdominal wall hernia, with afferent loop dilation measuring up to 3.4 cm. He was evaluated by the General Surgery consultation service and underwent an emergent laparoscopic hernia repair. There was 5 cm of small bowel noted to be ecchymotic but viable, with no devitalized tissue. He tolerated the surgical intervention with no post-operative complications and was discharged home. Conclusions Ultrasound-guided bedside paracentesis is a common procedure used in the management of refractory ascites and abdominal wall hernia incarceration should be recognized as a potential rare complication. To prevent hernia incarceration, patients with liver cirrhosis should be examined closely for hernias and an attempt should be made for external reduction prior to LVP. A high index of suspicion for this potential life-threatening condition should be had in patients who present with symptoms of bowel obstruction following a LVP. Funding Agencies None

scholarly journals Chylous ascites following elective abdominal aortic aneurysm repair

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Sylvie Bowden ◽  
Mohammed Firdouse ◽  
Graham Roche-Nagle
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Rare Complication ◽  
Somatostatin Analogs ◽  
Chylous Ascites ◽  
Abdominal Aortic Aneurysm Repair ◽  
Diagnostic Modality ◽  
Full Diet ◽  
Abdominal Aortic ◽  
Glue Embolization

Abstract Postoperative chylous ascites is a rare complication of abdominal surgery. Chyle depletion results in nutritional, immunologic and metabolic deficiencies, making it a serious and potentially life-threatening condition for which prompt diagnosis and management is imperative. A 72-year-old male was referred for open repair of a 62 cm juxtarenal abdominal aortic aneurysm (AAA). Following resumption of diet, he developed abdominal distention. Therapeutic paracenteses confirmed chylous ascites. Failed conservative management and lymphatic embolization lead to surgical sealance of lymphatic leak using glue. Postoperatively, a full diet was tolerated with no further ascites. Paracentesis is the diagnostic modality of choice in evaluating patients with ascites. Management is challenging and should be multifaceted and tailored to individual patient needs. Cornerstones of therapy include correction of the underlying etiology and conservative measures. When conservative measures fail, other interventions can be considered, such as somatostatin analogs, surgical ligation or glue embolization.

Chylous Ascites as a Rare Complication After Abdominal Aortic Aneurysm Surgery

2011 ◽  
Vol 104 (5) ◽  
pp. 365-367 ◽  
Author(s):  
Naoto Fukunaga ◽  
Yu Shomura ◽  
Michihiro Nasu ◽  
Yukikatsu Okada
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Rare Complication ◽  
Chylous Ascites ◽  
Aneurysm Surgery ◽  
Abdominal Aortic ◽  
Aortic Aneurysm Surgery

scholarly journals A case of liver cirrhosis accompanied with chylothorax and chylous ascites after endoscopic sclerotherapy of esophageal varices.

1988 ◽  
Vol 77 (8) ◽  
pp. 1282-1283
Author(s):  
Shuji TOHDA ◽  
Akiyoshi YAMANAKA ◽  
Hirohumi KOBAYASHI ◽  
Takanori AMAKAWA
Keyword(s):  
Liver Cirrhosis ◽  
Esophageal Varices ◽  
Chylous Ascites ◽  
Endoscopic Sclerotherapy

scholarly journals A Case of Successful Conservative Treatment for Chylous Ascites After Living-Donor Liver Transplantation

2013 ◽  
Vol 97 (4) ◽  
pp. 360-362 ◽  
Author(s):  
Hiroaki Shiba ◽  
Shigeki Wakiyama ◽  
Takeshi Gocho ◽  
Yuichi Ishida ◽  
Takeyuki Misawa ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Rare Complication ◽  
Chylous Ascites ◽  
Biliary Cirrhosis ◽  
Donor Liver ◽  
Donor Liver Transplantation

Abstract A 46-year-old man underwent living-donor liver transplantation and splenectomy for primary biliary cirrhosis. On postoperative day 22, cloudiness of ascites increased, and triglyceride concentration in ascites was as high as 1046 mg/dL. With a diagnosis of chylous ascites, total parenteral nutrition was started. Nine days after starting total parenteral nutrition, cloudiness of ascites decreased, and triglycerides in ascites decreased to 93 mg/dL. Oral intake was restarted, and the patient was discharged on postoperative day 46. Chylous ascites is a rare complication after living-donor liver transplantation for which total parenteral nutrition may be useful.

scholarly journals Chylous ascites secondary to liver cirrhosis with special reference to lymphangiography and lipoprotein analysis of chylous ascites.

1985 ◽  
Vol 74 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Humio SAKURAI ◽  
Shoichi TOMONO ◽  
Yukihiko TSUCHIYA ◽  
Hideo TAKEUCHI ◽  
Hiroshige ITAKURA
Keyword(s):  
Liver Cirrhosis ◽  
Special Reference ◽  
Chylous Ascites

scholarly journals Chylous ascites after laparoscopic donor nephrectomy: First case report in Turkey

2021 ◽  
pp. 190-194
Author(s):  
Selçuk Şahin ◽  
Osman Özdemir ◽  
İsmail Evren ◽  
Serdar Karadağ ◽  
Volkan Tuğcu ◽  
...  
Keyword(s):  
Case Report ◽  
Rare Complication ◽  
Treatment Options ◽  
Chylous Ascites ◽  
Donor Nephrectomy ◽  
Free Fluid ◽  
Somatostatin Analogue ◽  
Laparoscopic Donor Nephrectomy ◽  
First Case ◽  
End Stage

Living-donor kidney transplantation is one of the treatment options of end-stage renal failure. In many transplant centers, laparoscopic live-donor transplantation is recognised as the standard pro- cedure. Chylous ascites (CA) is a very rare complication after laparoscopic donor nephrectomy (LDN). We aimed to present the management of the first case report in Turkey. 62-year-old male patient underwent laparoscopic transperitoneal left donor nephrectomy. One month after discharge, he was admitted with abdominal distention and imaging revealed diffuse free fluid in the abdomen. After diagnosis, milky colored chylous fluid was collected by inserting a percutenous drainage cathe- ter. The patient was treated with combination of percutaneous drainage, somatostatin analogue and total parenteral nutrition. Keywords: chylous ascites; laparoscopic donor nephrectomy; complication

scholarly journals Risk of Liver Cirrhosis and Hepatocellular Carcinoma after Fontan Operation: A Need for Surveillance

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1805
Author(s):  
Jun Sik Yoon ◽  
Dong Ho Lee ◽  
Eun Ju Cho ◽  
Mi Kyoung Song ◽  
Young Hun Choi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Cumulative Incidence ◽  
Rare Complication ◽  
Fontan Procedure ◽  
Fontan Operation ◽  
Late Complication ◽  
Elevated Serum ◽  
Arterial Phase ◽  
Portal Venous Phase

Liver cirrhosis and hepatocellular carcinoma (HCC) are serious late complications that can occur after the Fontan procedure. This study aimed to investigate the cumulative incidence of cirrhosis and HCC and to identify specific features distinguishing HCC from benign arterial-phase hyperenhancing (APHE) nodules that developed after the Fontan operation. We retrospectively enrolled 313 post-Fontan patients who had been followed for more than 5 years and had undergone ultrasound or computed tomography (CT) of the liver between January 2000 and August 2018. Cirrhosis was diagnosed radiologically. The estimated cumulative incidence rates of cirrhosis at 5, 10, 20, and 30 years after the Fontan operation were 1.3%, 9.2%, 56.6%, and 97.9%, respectively. Multiphasic CT revealed that 18 patients had APHE nodules that were ≥1 cm in size and showed washout in the portal venous phase (PVP)/delayed phase, which met current noninvasive HCC diagnosis criteria. Among them, only seven patients (38.9%, 7/18) were diagnosed with HCC. After cirrhosis developed, the annual incidence of HCC was 1.04%. The appearance of washout in the PVP (p = 0.006), long time elapsed since the initial Fontan operation (p = 0.04), large nodule size (p = 0.03), and elevated serum α-fetoprotein (AFP) level (p < 0.001) were significantly associated with HCC. In conclusion, cirrhosis is a frequent late complication after Fontan operation, especially after 10 years, and HCC is not a rare complication after cirrhosis development. Diagnosis of HCC should not be based solely on the current imaging criteria, and washout on PVP and clinical features might be helpful to differentiate HCC nodules from benign APHE nodules.

Chylous Ascites: An Unusual Complication of Peritoneal Dialysis. A Case Report and Literature Review

2008 ◽  
Vol 28 (3) ◽  
pp. 229-231 ◽  
Author(s):  
Chee Kay Cheung ◽  
Arif Khwaja
Keyword(s):  
Peritoneal Dialysis ◽  
Case Report ◽  
Literature Review ◽  
Rare Complication ◽  
Chylous Ascites ◽  
Catheter Insertion ◽  
Unusual Complication ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter

Chylous ascites is a rare complication in patients undergoing peritoneal dialysis. It may occur due to traumatic peritoneal dialysis catheter insertion or other causes. It is important to be aware of this condition as it may be confused with peritonitis, and antibiotics may be inappropriately administered. We report a case of chylous ascites occurring after catheter insertion and discuss management of this condition.

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