al-Mousawi M, Abu-Nema T
Department of Surgery, Mubarak Al-Kabeer Hospital, Kuwait.
Eur J Surg. 1991 Feb;157(2):149-50.
A previously healthy 30-year-old man underwent vagotomy and pyloroplasty for a chronic duodenal ulcer that had not responded to H2 blockers. On the third day his abdomen was slightly distended; this gradually increased and on the eighth day ascites was confirmed by ultrasonography. Paracentesis yielded 4 litres of milky, odorless fluid. He was treated by fat free diet as he refused parenteral nutrition and on day 15 a further two litres of fluid were withdrawn, this time straw coloured. By day 31 his abdomen had returned to normal and his serum albumin concentration (which had dropped to 26 g/l) had risen to 43 g/l. He has now remained well for two years. Chylous ascites is a rare complication of truncal vagotomy, but should be suspected if postoperative ascites develops. Early recognition and treatment are important.
一名30岁既往健康的男性因对H2受体阻滞剂无反应的慢性十二指肠溃疡接受了迷走神经切断术和幽门成形术。术后第三天，他的腹部稍有膨隆；这种情况逐渐加重，第八天经超声检查证实有腹水。腹腔穿刺抽出4升乳白色、无异味的液体。由于他拒绝接受肠外营养，故给予无脂饮食治疗，第15天又抽出2升液体，这次是淡黄色的。到第31天时，他的腹部已恢复正常，血清白蛋白浓度（已降至26 g/L）升至43 g/L。他现已健康存活两年。乳糜性腹水是迷走神经干切断术的一种罕见并发症，但如果术后出现腹水，应怀疑有此并发症。早期识别和治疗很重要。
