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RAPID RESOLUTION OF CHYLOUS ASCITES AFTER LIVER TRANSPLANTATION USING SOMATOSTATIN ANALOG AND TOTAL PARENTERAL NUTRITION

1996; Wolters Kluwer; Volume: 61; Issue: 9 Linguagem: Inglês

10.1097/00007890-199605150-00023

1534-6080

A. M. James Shapiro, Vincent G. Bain, David L. Sigalet, Norman M. Kneteman,

Vascular Malformations and Hemangiomas

Chylous ascites is the accumulation of chylomicronrich lymphatic fluid within the peritoneal cavity. It is a rare complication of retroperitoneal surgery, and may occur spontaneously in 0.5% of patients with cirrhosis. Its management is controversial, and despite a variety of treatment options with limited efficacy, the course is usually indolent. In this article, we report a case of rapid resolution of chylous ascites after liver transplantation following 10 days of treatment using somatostatin analog (Octreotide, 100 μg s.c. t.i.d.) and total parenteral nutrition (TPN). A 55-year-old man underwent liver transplantation for hepatitis C cirrhosis, and developed an infected chylous fistula on the 10th day. Treatment by fasting, TPN, and somatostatin analog resulted in a rapid falloff in fistula output, with complete resolution of ascites within 2 days. This is the first report, to our knowledge, of somatostatin analog and TPN used in combination for rapid and successful closure of a chylous fistula.