Postoperative chylous ascites is a well-known complication of retroperitoneal lymph node dissection for testicular malignancies. This complication is now being reported increasingly with laparoscopic nephrectomies as well. A 33-year-old woman with no comorbidities underwent laparoscopic left donor nephrectomy. She had an uneventful postoperative recovery and was discharged on the 5th postoperative day. She reported on the 11th postoperative day with abdominal distension. Clinical examination revealed free fluid in the peritoneal cavity, and she was evaluated further. Imaging revealed mild ascites, which was aspirated, yielding milky fluid. Biochemical analysis of the fluid revealed triglycerides and chylomicrons, consistent with chyle. She was admitted, and an intra-abdominal drain placed under ultrasound guidance. Subsequently, she underwent lymphangiography and embolization. Her drain output came down, and she remained asymptomatic following drain removal. There was no further chylous leak on subsequent follow-up. Chylous ascites following laparoscopic nephrectomy is more common on the left side. Chylous leaks have been attributed to incomplete sealing of lymphatics with energy devices. Precise surgical technique of division of lymphatics between clips can prevent this complication. Most small leaks settle with a conservative care. Those that do not settle require open ligation. Percutaneous lymphatic embolization is an effective minimally invasive modality in managing such patients.
机构:
UCLA, Med Ctr, Dept Radiol, Los Angeles, CA 90095 USAUCLA, Med Ctr, Dept Radiol, Los Angeles, CA 90095 USA
Lee, Edward Wolfgang
;
Shin, Ji Noon
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Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul 138736, South Korea
Univ Ulsan, Coll Med, Asan Med Ctr, Res Inst Radiol, Seoul 138736, South KoreaUCLA, Med Ctr, Dept Radiol, Los Angeles, CA 90095 USA
Shin, Ji Noon
;
Ko, Heung Kyu
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机构:
Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul 138736, South Korea
Univ Ulsan, Coll Med, Asan Med Ctr, Res Inst Radiol, Seoul 138736, South KoreaUCLA, Med Ctr, Dept Radiol, Los Angeles, CA 90095 USA
Ko, Heung Kyu
;
Park, Jihong
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机构:
Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul 138736, South Korea
Univ Ulsan, Coll Med, Asan Med Ctr, Res Inst Radiol, Seoul 138736, South KoreaUCLA, Med Ctr, Dept Radiol, Los Angeles, CA 90095 USA
Park, Jihong
;
Kim, Soo Hwan
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机构:
Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul 138736, South Korea
Univ Ulsan, Coll Med, Asan Med Ctr, Res Inst Radiol, Seoul 138736, South KoreaUCLA, Med Ctr, Dept Radiol, Los Angeles, CA 90095 USA
Kim, Soo Hwan
;
Sung, Kyu-Bo
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机构:
Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul 138736, South Korea
Univ Ulsan, Coll Med, Asan Med Ctr, Res Inst Radiol, Seoul 138736, South KoreaUCLA, Med Ctr, Dept Radiol, Los Angeles, CA 90095 USA
机构:
UCLA, Med Ctr, Dept Radiol, Los Angeles, CA 90095 USAUCLA, Med Ctr, Dept Radiol, Los Angeles, CA 90095 USA
Lee, Edward Wolfgang
;
Shin, Ji Noon
论文数: 0引用数: 0
h-index: 0
机构:
Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul 138736, South Korea
Univ Ulsan, Coll Med, Asan Med Ctr, Res Inst Radiol, Seoul 138736, South KoreaUCLA, Med Ctr, Dept Radiol, Los Angeles, CA 90095 USA
Shin, Ji Noon
;
Ko, Heung Kyu
论文数: 0引用数: 0
h-index: 0
机构:
Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul 138736, South Korea
Univ Ulsan, Coll Med, Asan Med Ctr, Res Inst Radiol, Seoul 138736, South KoreaUCLA, Med Ctr, Dept Radiol, Los Angeles, CA 90095 USA
Ko, Heung Kyu
;
Park, Jihong
论文数: 0引用数: 0
h-index: 0
机构:
Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul 138736, South Korea
Univ Ulsan, Coll Med, Asan Med Ctr, Res Inst Radiol, Seoul 138736, South KoreaUCLA, Med Ctr, Dept Radiol, Los Angeles, CA 90095 USA
Park, Jihong
;
Kim, Soo Hwan
论文数: 0引用数: 0
h-index: 0
机构:
Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul 138736, South Korea
Univ Ulsan, Coll Med, Asan Med Ctr, Res Inst Radiol, Seoul 138736, South KoreaUCLA, Med Ctr, Dept Radiol, Los Angeles, CA 90095 USA
Kim, Soo Hwan
;
Sung, Kyu-Bo
论文数: 0引用数: 0
h-index: 0
机构:
Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul 138736, South Korea
Univ Ulsan, Coll Med, Asan Med Ctr, Res Inst Radiol, Seoul 138736, South KoreaUCLA, Med Ctr, Dept Radiol, Los Angeles, CA 90095 USA