Postoperative Chylous Ascites in Gynecological Malignancies: Case report
Chylous ascites (CA) is a rare condition caused by disruption of the lymphatic system, with the accumulation of milky triglyceride-rich chyle in the peritoneal cavity. Multiple etiologies have been reported, including traumatic, congenital, infectious, neoplastic, postoperative, cirrhotic, or cardiogenic.
The symptoms of CA are nonspecific. The most typical feature is abdominal distention, followed by indigestion, nausea, and vomiting. The severity depends on the amount of ascitic fluid and its accumulation rate, as well as the patient’s health condition. Serious cases of peritonitis and ileus have also been reported. In some cases, deterioration with environmental disturbances and immunological dysfunctions have also been reported. Treatment strategies for postoperative CA are broadly divided into two categories, namely, conservative management (dietary restriction and medical therapy) and surgery. Conservative management, which aimed to reduce the production of chyle and promote closure of the fistula, is successful in most cases. Surgical intervention is usually performed following unsuccessful conservative management.
Postoperative CA is infrequent after gynecological surgery. Most available studies are case reports. Experience in the prevention, diagnosis, and treatment of postoperative CA is lacking. Here, authors described two cases of postoperative CA following gynecological surgeries and reviewed the relevant articles on patients with gynecological malignancies and postoperative CA. This study aimed to describe the clinical features of CA after gynecological surgery and to determine the potential factors associated with its prognosis.
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