Llerena Freire Luis F, Llerena Freire Giannella I
School of Medicine, Pontificia Universidad Católica del Ecuador - Ambato Campus Avenida Manuela Sáenz and Marieta de Veintimilla Atocha - Ficoa Ambato, Tungurahua 180150, Ecuador.
Universidad de Las Américas, José Queri and Av. de los Granados, UDLA Granados Campus, Quito, Pichincha 170135, Ecuador.
J Surg Case Rep. 2025 Aug 11;2025(8):rjaf622. doi: 10.1093/jscr/rjaf622. eCollection 2025 Aug.
Chylous ascites is the accumulation of lymphatic fluid in the peritoneal cavity due to disruption or obstruction of abdominal lymphatic vessels. It typically presents as painless abdominal distention and is diagnosed by the presence of elevated triglycerides in the ascitic fluid. Although malignancy is the most common cause, abdominal surgery should also be considered in the differential diagnosis. Treatment is primarily conservative and includes a high-protein, low-fat diet with medium-chain triglyceride supplementation. In cases with poor response or contraindications to enteral nutrition, total parenteral nutrition is indicated, reserving surgical intervention for refractory cases. We report a rare case of chylous ascites following a robot-assisted D3 extended right hemicolectomy, successfully managed with conservative therapy.
乳糜性腹水是由于腹部淋巴管破裂或阻塞导致腹腔内淋巴液积聚。其典型表现为无痛性腹胀，通过腹水甘油三酯升高来诊断。虽然恶性肿瘤是最常见的病因，但在鉴别诊断中也应考虑腹部手术史。治疗主要是保守治疗，包括高蛋白、低脂饮食并补充中链甘油三酯。对于肠内营养反应不佳或有禁忌证的病例，应采用全胃肠外营养，难治性病例则需手术干预。我们报告1例机器人辅助D3扩大右半结肠切除术后发生乳糜性腹水的罕见病例，经保守治疗成功治愈。
