PP 68 BEWARE OF THE MILKY FLUIDS POST ABDOMINAL SURGERY

Abstract

INTRODUCTION

Chylous ascites is defined as a pathologic accumulation of chyle in the peritoneal cavity. The incident of chylous ascites following inferior vena cava tumour resection is rare.

CASE REPORT

We reported a case of inferior vena cava leiomyosarcoma. She underwent resection of the tumour with reconstruction of the inferior vena cava and bilateral renal vein using a graft. Intraoperatively was uneventful. At postoperative day 10, patient was noted to have a large amount of milky discharge from the laparotomy wound. The diagnosis of chyle leak was confirmed by fluid analysis that showed to have high triglyceride content. Computed tomography of the abdomen showed perihepatic collection which was connected to a subcutaneous collection. Aspiration under ultrasound guidance was done for both the perihepatic and subcutaneous collection. 60 ml of chyle aspirated. After that collection of the chyle was done by putting a stoma bag at the wound. The wound was dry 1 month post operation. Repeat ultrasonography of the abdomen showed minimal collection at the hepatic region.

CONCLUSION

Chylous ascites following of Inferior Vena Cava tumour resection is rare. It is commonly due to traumatic disruption of lymphatic during the surgery. Most of the patients are successfully treated conservatively.