CHYLOPERITONEUM AFTER GASTRECTOMY: IS IT A MANAGEABLE NIGHTMARE?
Autor(a) principal: | |
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Data de Publicação: | 2024 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.34635/rpc.1012 |
Resumo: | Chylous ascites is a serious and rare complication after gastrectomy for gastric cancer. Most cases improve with conservative treatment, but substantial morbidity and mortality can be associated. We describe the case of a 48-year-old-male submitted to partial gastrectomy with D2 lymphadenectomy for gastric adenocarcinoma. Three days after starting a liquid diet, it was diagnosed a chyle fistula. Conservative treatment was started with improvement of the patient and he was discharged. After eighteen days, the patient was readmitted due to a large volume chyloperitoneum, requiring paracentesis. Medical treatment was reinstituted, with amelioration and dismissal of the patient. The patient returned to the emergency department due to abdominal pain and fever and was submitted to laparoscopic abdominal drainage. There was resolution of refractory ascites during hospitalization. Chylous ascites is a rare complication after radical resections for gastric cancer. Therefore, there is no well-defined treatment and these cases remain a therapeutic challenge. The therapeutic strategies described include dietary measures, the use of pharmacological agents, total parenteral nutrition and, in selected cases, surgical or percutaneous interventions. |
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CHYLOPERITONEUM AFTER GASTRECTOMY: IS IT A MANAGEABLE NIGHTMARE?QUILOPERITONEU APÓS GASTRECTOMIA: É UM PESADELO CONTROLÁVEL?Chylous ascites is a serious and rare complication after gastrectomy for gastric cancer. Most cases improve with conservative treatment, but substantial morbidity and mortality can be associated. We describe the case of a 48-year-old-male submitted to partial gastrectomy with D2 lymphadenectomy for gastric adenocarcinoma. Three days after starting a liquid diet, it was diagnosed a chyle fistula. Conservative treatment was started with improvement of the patient and he was discharged. After eighteen days, the patient was readmitted due to a large volume chyloperitoneum, requiring paracentesis. Medical treatment was reinstituted, with amelioration and dismissal of the patient. The patient returned to the emergency department due to abdominal pain and fever and was submitted to laparoscopic abdominal drainage. There was resolution of refractory ascites during hospitalization. Chylous ascites is a rare complication after radical resections for gastric cancer. Therefore, there is no well-defined treatment and these cases remain a therapeutic challenge. The therapeutic strategies described include dietary measures, the use of pharmacological agents, total parenteral nutrition and, in selected cases, surgical or percutaneous interventions.A ascite quilosa é uma complicação grave e rara após gastrectomia por cancro gástrico. A maioria dos casos melhora com tratamento conservador, mas morbidade e mortalidade substanciais podem estar associadas. Descrevemos o caso de um homem de 48 anos submetido a gastrectomia parcial com linfadenectomia D2 por adenocarcinoma gástrico. Três dias após início de dieta líquida, foi diagnosticada fístula de quilo. Foi iniciado tratamento conservador com melhora do paciente e ele recebeu alta. Após dezoito dias, o paciente foi readmitido por apresentar quiloperitônio de grande volume, necessitando de paracentese. O tratamento médico foi reinstituído, com melhora e alta do paciente. O paciente retornou ao pronto-socorro por dor abdominal e febre e foi submetido à drenagem abdominal laparoscópica. Houve resolução da ascite refratária durante a internação. Ascite quilosa é uma complicação rara após ressecções radicais para câncer gástrico. Portanto, não existe um tratamento bem definido e esses casos permanecem um desafio terapêutico. As estratégias terapêuticas descritas incluem medidas dietéticas, uso de agentes farmacológicos, nutrição parenteral total e, em casos selecionados, intervenções cirúrgicas ou percutâneas.Sociedade Portuguesa de Cirurgia2024-01-11info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.34635/rpc.1012https://doi.org/10.34635/rpc.1012Revista Portuguesa de Cirurgia; No 56 (2023): December; 89-94Revista Portuguesa de Cirurgia; No 56 (2023): December; 89-942183-11651646-6918reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://revista.spcir.com/index.php/spcir/article/view/1012https://revista.spcir.com/index.php/spcir/article/view/1012/700Copyright (c) 2024 Revista Portuguesa de Cirurgiainfo:eu-repo/semantics/openAccessCastro, BárbaraOrtigosa, CatarinaTavares, AméliaViveiros, FernandoOliveira, Manuel2024-03-14T22:05:41Zoai:revista.spcir.com:article/1012Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T04:00:57.171522Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
CHYLOPERITONEUM AFTER GASTRECTOMY: IS IT A MANAGEABLE NIGHTMARE? QUILOPERITONEU APÓS GASTRECTOMIA: É UM PESADELO CONTROLÁVEL? |
title |
CHYLOPERITONEUM AFTER GASTRECTOMY: IS IT A MANAGEABLE NIGHTMARE? |
spellingShingle |
CHYLOPERITONEUM AFTER GASTRECTOMY: IS IT A MANAGEABLE NIGHTMARE? Castro, Bárbara |
title_short |
CHYLOPERITONEUM AFTER GASTRECTOMY: IS IT A MANAGEABLE NIGHTMARE? |
title_full |
CHYLOPERITONEUM AFTER GASTRECTOMY: IS IT A MANAGEABLE NIGHTMARE? |
title_fullStr |
CHYLOPERITONEUM AFTER GASTRECTOMY: IS IT A MANAGEABLE NIGHTMARE? |
title_full_unstemmed |
CHYLOPERITONEUM AFTER GASTRECTOMY: IS IT A MANAGEABLE NIGHTMARE? |
title_sort |
CHYLOPERITONEUM AFTER GASTRECTOMY: IS IT A MANAGEABLE NIGHTMARE? |
author |
Castro, Bárbara |
author_facet |
Castro, Bárbara Ortigosa, Catarina Tavares, Amélia Viveiros, Fernando Oliveira, Manuel |
author_role |
author |
author2 |
Ortigosa, Catarina Tavares, Amélia Viveiros, Fernando Oliveira, Manuel |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Castro, Bárbara Ortigosa, Catarina Tavares, Amélia Viveiros, Fernando Oliveira, Manuel |
description |
Chylous ascites is a serious and rare complication after gastrectomy for gastric cancer. Most cases improve with conservative treatment, but substantial morbidity and mortality can be associated. We describe the case of a 48-year-old-male submitted to partial gastrectomy with D2 lymphadenectomy for gastric adenocarcinoma. Three days after starting a liquid diet, it was diagnosed a chyle fistula. Conservative treatment was started with improvement of the patient and he was discharged. After eighteen days, the patient was readmitted due to a large volume chyloperitoneum, requiring paracentesis. Medical treatment was reinstituted, with amelioration and dismissal of the patient. The patient returned to the emergency department due to abdominal pain and fever and was submitted to laparoscopic abdominal drainage. There was resolution of refractory ascites during hospitalization. Chylous ascites is a rare complication after radical resections for gastric cancer. Therefore, there is no well-defined treatment and these cases remain a therapeutic challenge. The therapeutic strategies described include dietary measures, the use of pharmacological agents, total parenteral nutrition and, in selected cases, surgical or percutaneous interventions. |
publishDate |
2024 |
dc.date.none.fl_str_mv |
2024-01-11 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.34635/rpc.1012 https://doi.org/10.34635/rpc.1012 |
url |
https://doi.org/10.34635/rpc.1012 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://revista.spcir.com/index.php/spcir/article/view/1012 https://revista.spcir.com/index.php/spcir/article/view/1012/700 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2024 Revista Portuguesa de Cirurgia info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2024 Revista Portuguesa de Cirurgia |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Cirurgia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Cirurgia |
dc.source.none.fl_str_mv |
Revista Portuguesa de Cirurgia; No 56 (2023): December; 89-94 Revista Portuguesa de Cirurgia; No 56 (2023): December; 89-94 2183-1165 1646-6918 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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