Barrera Leidy, Gonzalez Diego, Pelaez Luisa
General Medicine, Universidad Pontificia Bolivariana, Medellin, COL.
Oncology, Instituto de Cancerologia Las Américas, Medellin, COL.
Cureus. 2023 May 8;15(5):e38716. doi: 10.7759/cureus.38716. eCollection 2023 May.
Chylous ascites is an uncommon complication seen in patients who have received radiotherapy to the abdomen. However, the morbidity caused by peritoneal ascites makes this an important complication to be considered when giving abdominal radiation to oncology patients We present the case of a 58-year-old woman with gastric adenocarcinoma, who consulted for recurrent ascites after receiving abdominal radiotherapy as an adjuvant treatment to surgery. Different tests were carried out to evaluate the cause. Malignant abdominal relapse and infection were ruled out. Paracentesis evidenced swallowed fluid, therefore, the possibility of chylous ascites due to radiotherapy was considered. Intrathoracic, abdominal, and pelvic lymphangiography was performed with Lipiodol and the absence of cisterna chyli was confirmed as the cause of refractory ascites. After the diagnosis, the patient went under aggressive in-hospital nutritional support treatment, with clinico-radiological response.
乳糜性腹水是腹部接受放疗患者中罕见的并发症。然而，腹膜腹水引起的发病率使这成为肿瘤患者腹部放疗时需考虑的重要并发症。我们报告一例58岁胃腺癌女性患者，她在接受腹部放疗作为手术辅助治疗后因反复腹水前来咨询。进行了不同检查以评估病因。排除了恶性腹部复发和感染。腹腔穿刺抽出乳糜液，因此考虑放疗导致乳糜性腹水的可能性。用碘油进行了胸、腹及盆腔淋巴管造影，证实乳糜池缺如为顽固性腹水的病因。诊断明确后，患者接受了积极的院内营养支持治疗，临床及影像学有反应。
