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Postoperative chylous ascites is a rare complication following retroperitoneal surgeries, presenting significant challenges in diagnosis and management. Retroperitoneal cyst surgery resulting in chylous leaks is an uncommon complication that has not been previously reported in the literature. Therefore, we report a clinical case of postoperative chylous ascites following retroperitoneal cyst removal with underlying idiopathic thoracic duct obstruction.
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Extra-adrenal, functional paraganglioma, if not medically controlled, requires early surgical resection. This can often be challenging when found in a retroperitoneal location, where resections are prone to lymphatic disruption and chyle leaks. Chylous ascites carry a significant risk of protein and caloric malnutrition, dehydration, and even mortality given the nutrient-rich characteristic of lost lymphatic fluid.
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Chylous ascites, a rare but severe complication of abdominal surgery, often results from lymphatic vessel damage during procedures, such as extended resection and lymphadenectomy. Although conservative management through dietary modifications and medications is the primary approach, refractory cases may lead to severe complications including nutritional deficiencies and even death. Herein, we report a case of refractory chylous ascites that progressed to chylothorax after extended right hepatectomy with lymph node dissection for intrahepatic cholangiocarcinoma.
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