Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492009000200017
Jornal Vascular Brasileiro
Case report

Tratamento cirúrgico da ascite quilosa

Claudia Stein Gomes; Gustavo Ioshio Handa; Fabio Porto Silveira; Vinicius Zendrini Buzingnani; Fernanda Macedo Binati; Elizana Stella Lopes Rasera

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Resumo

A ascite quilosa é uma complicação rara após procedimentos cirúrgicos e trauma abdominal, apresentando elevada morbidade e difícil manejo. Nos casos refratários ao tratamento clínico habitual, o tratamento cirúrgico se impõe, apesar da baixa taxa de sucesso. Dois casos são apresentados: o primeiro paciente foi vítima de trauma abdominal contuso e o segundo foi submetido a hernioplastia hiatal a Nissen videolaparoscópica, ambos evoluindo com ascite quilosa que necessitou de tratamento cirúrgico através da ligadura do ducto torácico, junto aos pilares diafragmáticos. Os pacientes evoluíram com melhora clínica e ausência de ascite após 24 meses de seguimento.

Palavras-chave

Ascite quilosa, doenças linfáticas, laparoscopia

References

Cárdenas A, Chopra S. Chylous ascites. Am J Gastroenterol.. 2002;97:1896-9000.

Browse NL, Wilson NM, Russo F, Al-Hassan H, Allen DR. Aetiology and treatment of chylous ascites. Br J Surg.. 1992;79:1145-50.

Leibovich I, Mor Y, Golomb J, Ramon J. The diagnosis and management of postoperative chylous ascites. J Urol.. 2002;167:449-57.

Bacelar TS, de Albuquerque AC, de Arruda PC, Ferraz AA, Ferraz EM. Postoperative chylous ascites: a rare complication of laparoscopic Nissen fundoplication. JSLS.. 2003;7:269-71.

Doerr CH, Allen MS, Nichols FC 3rd, Ryu JH. Etiology of chylothorax in 203 patients. Mayo Clin Proc.. 2005;80:867-70.

Aalami OO, Allen DB, Organ CH Jr. Chylous ascites: a collective review. Surgery.. 2000;128:761-78.

Runyon BA, Hoefs JC, Morgan TR. Ascitic fluid analysis in malignancy-related ascites. Hepatology.. 1988;8:1104-9.

Pui MH, Yueh TC. Lymphoscintigraphy in chyluria, chyloperitoneum and chylothorax. J Nuc Med.. 1998;39:1292-6.

Lee YY, Soong WJ, Lee YS, Hwang B. Total parenteral nutrition as a primary therapeutic modality for congenital chylous ascites: report of one case. Acta Paediatr Taiwan.. 2002;43:214-6.

Alliët P, Young C, Lebenthal E. Chylous ascites: total parenteral nutrition as primary therapeutic modality. Eur J Pediatr.. 1992;151:213-4.

Leong, RW, House, AK, Jeffrey, GP. Chylous ascites caused by portal vein thrombosis treated with octreotide. J Gastroenterol Hepatol.. 2003;18:1211.

Mincher L, Evans J, Jenner MW, Varney VA. The successful treatment of chylous effusions in malignant disease with octreotide. Clin Oncol (R Coll Radiol).. 2005;17:118-21.

Huang Q, Jiang ZW, Jiang J, Li N, Li JS. Chylous ascites: treated with total parenteral nutrition and somatostatin. World J Gastroenterol.. 2004;10:2588-91.

Jensen EH, Weiss CA 3rd. Management of chylous ascites after laparoscopic cholecystectomy using minimally invasive techniques: a case report and literature review. Am Surg.. 2006;72:60-3.

Busch T, Lotfi S, Sirbu H, Aleksic I, Dalichau H. Chyloperitoneum. A rare complication after abdominal aortic aneurysm repair. J Cardiovasc Surg.. 2000;41:617-8.

LeVeen HH, Wapnick S, Grosberg S, Kinney MJ. Further experience with peritoneo-venous shunt for ascites. Ann Surg.. 1976;184:574-81.

Sarazin WG, Sauter KE. Chylous ascites following resection of a ruptured abdominal aneurysm. Treatment with a peritoneovenous shunt. Arch Surg.. 1986;121:246-7.

Fleisher HL 3rd, Oren JW, Sumner DS. Chylous ascites after abdominal aortic aneurysmectomy: successful management with a peritoneovenous shunt. J Vasc Surg.. 1987;6:403-7.

Press OW, Press NO, Kaufman SD. Evaluation and management of chylous ascites. Ann Intern Med.. 1982;96:358-64.

Ablan CJ, Littooy FN, Freeark RJ. Postoperative chylous ascites: diagnosis and treatment. A series report and literature review. Arch Surg.. 1990;125:270-3.

Voros D, Hadziyannis S. Successful management of postoperative chylous ascites with a peritoneojugular shunt. J Hepatol.. 1995;22:380.

Skala J, Witte C, Bruna J, Case T, Finley P. Chyle leakage after blunt trauma. Lymphology.. 1992;25:62-8.

Meinke AH 3rd, Estes NC, Ernst CB. Chylous ascites following abdominal aortic aneurysmectomy. Management with total parenteral hyperalimentation. Ann Surg.. 1979;190:631-3.

Beal AL, Gormley CM, Gordon DL, Ellis CM. Chylous ascites: a manifestation of blunt abdominal trauma in an infant. J Pediatr Surg.. 1998;33:650-2.

Vollman R, Keenan W, Eraklis A. Post traumatic chylous ascites in infancy. N Eng J Med.. 1966;275:875-7.

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