Chylous ascites following para-aortic lymphadenectomy: a case report

Background. Chylous ascites is an uncommon complication following para-aortic lymph node dissection in the management of gynecologic malignancies. Treatment options are serial paracentesis, medium-chain triglyceride diet, total parenteral nutrition and somatostatin as conservative management and peritoneovenous shunting, and surgical exploration for refractory cases. Case. A 31-year-old female patient developed chylous ascites following para-aortic lymph node dissection for borderline mucinous tumor of the ovary. Conservative management options failed with recurrence of chylous ascites. Chylous ascites resolved after surgical closure of the lymphatic fistula on the cisterna chyli. There was no evidence of ascites at 10 months follow-up. Conclusion. If the patient is a good surgical candidate, surgical exploration should be considered earlier in the treatment of refractory chylous ascites. (C) 2004 Elsevier Inc. All rights reserved.