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供者移植术后乳糜性腹腔积液 1 例报告

A Case Report of Chyloretroperitoneum Post Living-Donor Transplantation.

机构信息

Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan,

Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.

出版信息

Urol Int. 2020;104(1-2):160-162. doi: 10.1159/000497108. Epub 2019 Feb 20.

Abstract

Chyloretroperitoneum is a rare complication of urological surgery. Here we report a case of chyloretroperitoneum that occurred in a 28-year-old man post living-donor transplantation. Twenty-nine days post transplantation, perirenal fluid collection and hydronephrosis were detected and percutaneous drainage was performed. The fluid was chylous and revealed a very high triglyceride concentration (1,197 mg/dL). Total parenteral nutrition and administration of octreotide were performed, but the leakage did not improve. On the contrary, the drainage fluid gradually increased to 1,600 mL/day, and a laparoscopic fenestration was performed owing to a concern about the adverse effects of massive lymph loss. Ascites temporarily appeared but disappeared 3 months post fenestration. To our knowledge, this is the first case report of pelvic chyloretroperitoneum post living-donor transplantation. Furthermore, if chyloretroperitoneum treatment using diet control or octreotide is ineffective, laparoscopic fenestration can be considered as a treatment option.

摘要

乳糜性 Retroperitoneum 是泌尿科手术的罕见并发症。在这里,我们报告了一例发生在活体供肾移植后 28 岁男性的乳糜性 Retroperitoneum 病例。移植后 29 天,发现肾周积液和肾盂积水,并进行了经皮引流。引流液为乳糜样,甘油三酯浓度非常高(1197mg/dL)。进行了全肠外营养和奥曲肽治疗,但漏液并未改善。相反,引流液逐渐增加到每天 1600ml,由于担心大量淋巴液丢失的不良影响,进行了腹腔镜开窗术。腹水暂时出现,但在开窗术后 3 个月消失。据我们所知,这是首例活体供肾移植后盆腔乳糜性 Retroperitoneum 的病例报告。此外,如果饮食控制或奥曲肽治疗乳糜性 Retroperitoneum 无效,可以考虑腹腔镜开窗术作为治疗选择。

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