Bauwens K, Jacobi C A, Gellert K, Aurisch R, Zieren H U
Klinik und Poliklinik für Chirurgie, Charité, Humboldt Universität zu Berlin.
Chirurg. 1996 Jun;67(6):658-60.
Chyloperitoneum is a rare complication of surgical procedures. We report a case of severe chyloperitoneum after abdominothoracic esophageal resection with two-field lymphadenectomy. After diagnosis was established, the lymph leak was located with oral iodine-marked fatty acids (123I-pentadecanoic acid) showing increased activation in the right middle abdomen. Because conservative treatment with total parenteral nutrition showed no decrease in chyle volume, relaparatomy was performed and the lymphatic fistula was successfully treated with suture ligatures. Pathophysiology and different options for localization and treatment of postoperative chyloperitoneum are discussed.
乳糜腹是手术操作中一种罕见的并发症。我们报告一例经腹胸段食管切除术加两野淋巴结清扫术后发生严重乳糜腹的病例。确诊后，采用口服碘标记脂肪酸（123I-十五烷酸）定位淋巴漏，显示右中腹部放射性增强。由于全肠外营养的保守治疗未能使乳糜量减少，故再次剖腹手术，通过缝合结扎成功治疗了淋巴瘘。本文讨论了术后乳糜腹的病理生理学以及定位和治疗的不同选择。
