Tom P Manolitsas1, Shahab Abdessalam, Jeffrey M Fowler. 1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The James Cancer Hospital and Solove Research Institute, Ohio State University College of Medicine, M-210 Starling Loving, 320 West 10th Avenue, Columbus, OH 43210-1228, USA.
Abstract
BACKGROUND: Chylous ascites is a rare complication following abdominal radiation or para-aortic lymph node dissection in the management of gynecologic malignancies. Treatment options include dietary restriction with addition of medium-chain triglycerides, serial paracenteses, total parenteral nutrition, and somatostatin. Current opinion advocates that surgical exploration and peritoneo-venous shunts be reserved for refractory cases. CASES: Two patients developed chylous ascites, one after completion of surgical staging and chemoradiation for stage IIB squamous carcinoma of the cervix and one following para-aortic lymph node dissection for recurrent malignant mixed mullerian tumor of the endometrium. In both cases resolution of the chylous ascites followed placement of a peritoneo-venous shunt. CONCLUSIONS: Chylous ascites should be considered in the differential diagnosis of ascites in patients with gynecologic malignancy treated with radiation or para-aortic lymph node dissection.
BACKGROUND:Chylous ascites is a rare complication following abdominal radiation or para-aortic lymph node dissection in the management of gynecologic malignancies. Treatment options include dietary restriction with addition of medium-chain triglycerides, serial paracenteses, total parenteral nutrition, and somatostatin. Current opinion advocates that surgical exploration and peritoneo-venous shunts be reserved for refractory cases. CASES: Two patients developed chylous ascites, one after completion of surgical staging and chemoradiation for stage IIB squamous carcinoma of the cervix and one following para-aortic lymph node dissection for recurrent malignant mixed mullerian tumor of the endometrium. In both cases resolution of the chylous ascites followed placement of a peritoneo-venous shunt. CONCLUSIONS:Chylous ascites should be considered in the differential diagnosis of ascites in patients with gynecologic malignancy treated with radiation or para-aortic lymph node dissection.
Authors: Hooman Yarmohammadi; Lynn A Brody; Joseph P Erinjeri; Anne M Covey; F Edward Boas; Etay Ziv; Majid Maybody; Adrian J Gonzalez-Aguirre; Karen T Brown; Joel Sheinfeld; George I Getrajdman Journal: J Vasc Interv Radiol Date: 2016-03-07 Impact factor: 3.464