Successful management of chylous ascites after pancreatoduodenectomy using etilefrine: a case report

Oxford Medical Case Reports
Yusuke Takahashi, Hitoshi Seki

Abstract

An 84-year-old woman underwent subtotal stomach pancreatoduodenectomy (PD) for distal cholangiocarcinoma. Over 1000 ml of serous ascites, which appeared milky after starting a high-protein, low-fat, middle-chain triglyceride diet, was discharged from the inserted drain. On postoperative day (POD) 13, she underwent right hemicolectomy for transverse colonic volvulus, which occurred on POD 9 and was refractory to conservative therapies. Following second surgery, the chylous ascites (CA) amount continued to increase. Octreotide, albumin and diuretics were administered, but the amount of ascites did not decrease. Etilefrine was administered on POD 19; the ascites amount gradually decreased. The drain was removed 3 days after etilefrine administration. She had no symptoms of abdominal distention after drain removal. Etilefrine's effectiveness for chylothorax after esophagectomy and CA after distal pancreatectomy has been reported. We present a case of CA successfully treated by etilefrine following PD. Our case highlights etilefrine's usefulness for CA following PD.

References

Aug 31, 1999·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·P GuillemJ P Triboulet
Aug 8, 2008·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Lia AssumpcaoTimothy M Pawlik
Jan 5, 2013·The British Journal of Surgery·S KubokiM Miyazaki
Mar 22, 2016·Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia·Shaan E AlamPran M Kar
Oct 21, 2016·The British Journal of Surgery·O StrobelM W Büchler

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