Panieri E, Kussman B D, Michell W L, Tunnicliffe J A, Immelman E J
Department of Surgery, Groote Schuur Hospital.
S Afr J Surg. 1995 Mar;33(1):26-8.
Chylous ascites is an extremely rare complication of abdominal aortic surgery. A case with a successful outcome is presented, followed by a review of the 17 published cases. Chylous ascites can result in nutritional imbalance, immunological deficit and respiratory dysfunction. Paracentesis confirms the diagnosis and provides symptomatic relief. Conservative management, beginning with a low-fat diet and medium-chain triglyceride (MCT) supplementation, is recommended, changing to total parenteral nutrition if unsuccessful. Failure of non-operative treatment may necessitate the need for laparotomy and ligation of leaking lymphatics or peritoneovenous shunting.
乳糜性腹水是腹主动脉手术极为罕见的并发症。本文报告了一例成功治愈的病例，并对已发表的17例病例进行了综述。乳糜性腹水可导致营养失衡、免疫缺陷和呼吸功能障碍。腹腔穿刺术可确诊并缓解症状。建议采用保守治疗，首先是低脂饮食并补充中链甘油三酯（MCT），若治疗失败则改为全胃肠外营养。非手术治疗失败可能需要进行剖腹手术并结扎渗漏的淋巴管或进行腹腔静脉分流术。
