Jofré Paulina, Grassi Bruno, Benítez Carlos
Departamento de Nutrición, Diabetes y Metabolismo, Pontificia Universidad Católica de Chile, Santiago, Chile.
Departamento de Gastroenterología, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rev Med Chil. 2020 Aug;148(8):1202-1206. doi: 10.4067/S0034-98872020000801202.
Chylous Ascites (CA) and chylothorax (CTx) are associated with obstruction, disruption or insufficiency of the lymphatic system. We report a 68-year-old male, with a history of alcoholic cirrhosis, who had recurrent events of CTx and CA. After a complete study, no other etiologies other than portal hypertension were found. Therapy with diuretics, nothing per mouth, parenteral feeding plus octreotide did not relieve symptoms. A transjugular intrahepatic portosystemic shunt (TIPS) was successfully placed and pleural effusion subsided. This case shows that CA and CTx can be caused by portal hypertension and they may subside employing a multimodal management strategy.
乳糜性腹水(CA)和乳糜胸(CTx)与淋巴系统的梗阻、破坏或功能不全有关。我们报告一例68岁男性,有酒精性肝硬化病史,曾反复发生CTx和CA。经过全面检查,除门静脉高压外未发现其他病因。使用利尿剂、禁食、肠外营养加奥曲肽治疗未能缓解症状。成功进行了经颈静脉肝内门体分流术(TIPS),胸腔积液消退。该病例表明,CA和CTx可由门静脉高压引起,采用多模式管理策略可能使其消退。