Chylous Ascites Following Abdominal Aortic Surgery

Russell A. Williams, John Vetto, William Quiñones-Baldrich, Frederic S. Bongard, Samuel E. Wilson

    Research output: Contribution to journalArticle

    26 Scopus citations

    Abstract

    Three patients, two women, one man (mean age 74 years), who had abdominal aortic aneurysms (2) or aortobifemoral surgery (1), developed chylous ascites postoperatively. They were studied to determine their clinical course and develop a plan for management of this complication. In each patient, the ascites was not manifest until abdominal swelling developed two weeks after operation, and the problem was confirmed by the finding of milky fluid on paracentesis. A low serum albumin (mean 2.6 gm) was also characteristic. The ascites was not altered by parenteral nutrition or reduction of dietary fat and ingestion of medium chain triglycerides. In one patient (man, age 93) the ascites resolved spontaneously two months after abdominal aortic aneurysm surgery. Another (woman, age 70) was cured following operative ligation of a lymphatic fistula identified at operation five weeks after abdominal aortic aneurysm repair. In the third (woman, age 60), the ascites resolved immediately following placement of a peritoneal venous shunt six weeks after an aortobifemoral bypass. Chylous ascites is rare after aortic surgery and manifests itself about two weeks after operation, at times after discharge from hospital. It has an indolent course, but may resolve spontaneously up to two months after operation. Its course appears not to be foreshortened by diet, including omission of fat, but can be successfully treated surgically with a shunt or fistula ligation. If done early a protracted hospital course may be avoided.

    Original languageEnglish (US)
    Pages (from-to)247-252
    Number of pages6
    JournalAnnals of Vascular Surgery
    Volume5
    Issue number3
    DOIs
    StatePublished - 1991

    Keywords

    • Chylous ascites
    • abdominal aortic operations
    • ascites

    ASJC Scopus subject areas

    • Surgery
    • Cardiology and Cardiovascular Medicine

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  • Cite this

    Williams, R. A., Vetto, J., Quiñones-Baldrich, W., Bongard, F. S., & Wilson, S. E. (1991). Chylous Ascites Following Abdominal Aortic Surgery. Annals of Vascular Surgery, 5(3), 247-252. https://doi.org/10.1007/BF02329381