Miller Heather, Anderson Matthew L, Smith Christopher P, Shamshirsaz Alireza A, Fox Karin A
Department of Obstetrics & Gynecology, Dan L. Duncan Cancer Center, and Scott Department of Urology, Baylor College of Medicine, Houston, Texas.
Obstet Gynecol. 2016 Nov;128(5):973-975. doi: 10.1097/AOG.0000000000001562.
Chylous ascites is defined as the pathologic accumulation of lymphatic fluid within the peritoneal cavity and has been reported to complicate gynecologic surgeries, with an incidence of 0.17-2%. We report a case of chylous ascites after complex surgery for placenta percreta.
A 26-year-old woman underwent cesarean delivery followed by bilateral uterine artery embolization and modified radical hysterectomy at 26 5/7 weeks of gestation for placenta percreta invading the urinary bladder. No surgical dissection was performed above the pelvic brim or deep into the pelvic sidewalls. On postoperative day 4, milky fluid consistent with chylous ascites was noted coming from a percutaneous drain. This completely resolved after 12 days of conservative management with intravenous nutritional support.
Chylous ascites is a potential complication of modified radical hysterectomy for placenta percreta that responds to conservative management.
乳糜性腹水被定义为腹腔内淋巴液的病理性积聚，据报道在妇科手术中会出现并发症，发生率为0.17%-2%。我们报告一例胎盘植入复杂手术后发生乳糜性腹水的病例。
一名26岁女性在妊娠26 5/7周时接受剖宫产，随后因胎盘植入侵犯膀胱接受双侧子宫动脉栓塞和改良根治性子宫切除术。未在骨盆边缘上方或深入骨盆侧壁进行手术解剖。术后第4天，经皮引流管引出乳白色液体，与乳糜性腹水相符。经过12天的静脉营养支持保守治疗后，腹水完全消退。
乳糜性腹水是胎盘植入改良根治性子宫切除术的潜在并发症，保守治疗有效。
