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Successful treatment of intractable chylous ascites after laparoscopic low anterior resection using lymphangiography and embolization with lipiodol: A case report

INTRODUCTION AND IMPORTANCE: Chylous ascites (CA) is an infrequent, intractable complication that may arise after abdominal surgery. Although various attempts at treatment have been adopted, to date, none of them have been consistently effective. We describe the successful treatment of CA using lymp...

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Autores principales: Ushijima, Hokuto, Hida, Jin-ichi, Haeno, Masahiro, Koda, Masashi, Ueda, Kazuki, Kawamura, Junichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8225989/
https://www.ncbi.nlm.nih.gov/pubmed/34153695
http://dx.doi.org/10.1016/j.ijscr.2021.106064
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author Ushijima, Hokuto
Hida, Jin-ichi
Haeno, Masahiro
Koda, Masashi
Ueda, Kazuki
Kawamura, Junichiro
author_facet Ushijima, Hokuto
Hida, Jin-ichi
Haeno, Masahiro
Koda, Masashi
Ueda, Kazuki
Kawamura, Junichiro
author_sort Ushijima, Hokuto
collection PubMed
description INTRODUCTION AND IMPORTANCE: Chylous ascites (CA) is an infrequent, intractable complication that may arise after abdominal surgery. Although various attempts at treatment have been adopted, to date, none of them have been consistently effective. We describe the successful treatment of CA using lymphangiography and embolization with lipiodol. CASE PRESENTATION: A 79-year-old woman underwent laparoscopic surgery for rectum cancer at another hospital. She was discharged on postoperative day (POD) 9; however, she had to be treated and hospitalized for CA three times until POD 76. She visited our hospital to undergo treatment for CA on POD 90 because the previous conservative treatment had not improved her condition. The computed tomography (CT) scans revealed ascites effusion. We performed lymphangiography and embolization with lipiodol two times. Repeated CT on POD 134 showed that the ascites had not increased. CLINICAL DISCUSSION: Lymphangiography and embolization with lipiodol effectively resolved chylous leakage that occurred after abdominal surgery. Additionally, we compare the features of two groups of cases of CA: one group in which patients were treated by lymphatic intervention and the second in which patients were treated through surgical procedures. CONCLUSION: We were thus able to demonstrate the clinical effectiveness of lipiodol lymphangiography in treating CA.
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spelling pubmed-82259892021-06-29 Successful treatment of intractable chylous ascites after laparoscopic low anterior resection using lymphangiography and embolization with lipiodol: A case report Ushijima, Hokuto Hida, Jin-ichi Haeno, Masahiro Koda, Masashi Ueda, Kazuki Kawamura, Junichiro Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Chylous ascites (CA) is an infrequent, intractable complication that may arise after abdominal surgery. Although various attempts at treatment have been adopted, to date, none of them have been consistently effective. We describe the successful treatment of CA using lymphangiography and embolization with lipiodol. CASE PRESENTATION: A 79-year-old woman underwent laparoscopic surgery for rectum cancer at another hospital. She was discharged on postoperative day (POD) 9; however, she had to be treated and hospitalized for CA three times until POD 76. She visited our hospital to undergo treatment for CA on POD 90 because the previous conservative treatment had not improved her condition. The computed tomography (CT) scans revealed ascites effusion. We performed lymphangiography and embolization with lipiodol two times. Repeated CT on POD 134 showed that the ascites had not increased. CLINICAL DISCUSSION: Lymphangiography and embolization with lipiodol effectively resolved chylous leakage that occurred after abdominal surgery. Additionally, we compare the features of two groups of cases of CA: one group in which patients were treated by lymphatic intervention and the second in which patients were treated through surgical procedures. CONCLUSION: We were thus able to demonstrate the clinical effectiveness of lipiodol lymphangiography in treating CA. Elsevier 2021-06-16 /pmc/articles/PMC8225989/ /pubmed/34153695 http://dx.doi.org/10.1016/j.ijscr.2021.106064 Text en © 2021 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Ushijima, Hokuto
Hida, Jin-ichi
Haeno, Masahiro
Koda, Masashi
Ueda, Kazuki
Kawamura, Junichiro
Successful treatment of intractable chylous ascites after laparoscopic low anterior resection using lymphangiography and embolization with lipiodol: A case report
title Successful treatment of intractable chylous ascites after laparoscopic low anterior resection using lymphangiography and embolization with lipiodol: A case report
title_full Successful treatment of intractable chylous ascites after laparoscopic low anterior resection using lymphangiography and embolization with lipiodol: A case report
title_fullStr Successful treatment of intractable chylous ascites after laparoscopic low anterior resection using lymphangiography and embolization with lipiodol: A case report
title_full_unstemmed Successful treatment of intractable chylous ascites after laparoscopic low anterior resection using lymphangiography and embolization with lipiodol: A case report
title_short Successful treatment of intractable chylous ascites after laparoscopic low anterior resection using lymphangiography and embolization with lipiodol: A case report
title_sort successful treatment of intractable chylous ascites after laparoscopic low anterior resection using lymphangiography and embolization with lipiodol: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8225989/
https://www.ncbi.nlm.nih.gov/pubmed/34153695
http://dx.doi.org/10.1016/j.ijscr.2021.106064
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