Study Design: Clinical case report.
Purpose: To report the rare case with post-operative chylous retroperitoneum after corrective surgery for adult spinal deformity.
Methods: We present a case of a 73-year-old woman with Parkinson's disease. She sustained a severe split fracture subluxation of the L3 vertebra with AO Spine Thoracolumbar classification type CN2M2, resulting in severe kyphoscoliosis in global alignment. She underwent a two-stage 720-degree anteroposterior-combined corrective surgery with anterior vertebral column resection of L3 and posterior fusion from T4 to the pelvis. On post-operative day 1, milky fluid in the drainage tube was noted, which was diagnosed as post-operative chylous retroperitoneum.
Results: Oral intake was discontinued immediately and peripheral parenteral nutrition was started. A low-fat, high-protein diet was started on post-operative day 4, and drainage was removed on day 6. A low-fat diet was continued until 3 months post-operatively, with dietary counselling by a nutritionist. The chylous retroperitoneum resolved without recurrence at the final follow-up evaluation at 3 years.
Conclusion: Surgeons should recognize this rare complication, which might be induced by direct damage to the lymphatic flow during an operative maneuver anterior to the lumbar vertebral body and indirect damage due to shearing force during correction of a subluxated vertebra, especially in cases with a severe deformity.
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http://dx.doi.org/10.1007/s43390-021-00309-3 | DOI Listing |
Am J Case Rep
January 2025
Department of Urology, Liaocheng Second People's Hospital, Liaocheng, Shandong, China.
BACKGROUND Surgery involving the right retroperitoneum can result in lymphatic (chylous) leakage from the cisterna chyli located anterior to the L1 and L2 vertebra or from lymph node dissection. This report describes a 46-year-old woman with retroperitoneal lymphatic (chylous) leak following right adrenalectomy for a nonfunctional adrenal adenoma. CASE REPORT A 46-year-old woman presented with a medical history of hypertension.
View Article and Find Full Text PDFBJU Int
December 2024
Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA.
Objectives: To provide current peri-operative outcomes and short-term complication rates for open primary retroperitoneal lymph node dissection (RPLND), with analysis of risk factors for complications.
Patients And Methods: Using the Indiana University Testicular Cancer database, we performed a retrospective analysis of all patients who underwent open primary RPLND over the study period (2018-2021). The primary outcomes of interest were the preoperative profile of patients undergoing surgery, complication rates, and identification of risk factors associated with complications.
Eur Urol Focus
May 2024
Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Surgery (Urology), Royal Melbourne Hospital, Melbourne, Australia; EJ Whitten Prostate Cancer Research Centre Epworth Hospital, Richmond, Victoria, Australia. Electronic address:
Chylous ascites is a rare but challenging complication after retroperitoneal lymph node dissection. Conservative management is successful in most cases, with percutaneous lymphangiography reserved for refractory instances. Surgical interventions are associated with high failure rates.
View Article and Find Full Text PDFCureus
February 2024
General Surgery, Prince Sultan Military Medical City, Riyadh , SAU.
Retroperitoneal chyloma is a rare entity that presents with non-specific symptoms. Although benign, it can cause complications due to the mass effect. In this case report, we present the case of a 24-year-old woman who presented with a complaint of left-sided colicky abdominal pain and mild dysuria for one year.
View Article and Find Full Text PDFGynecol Oncol Rep
August 2023
Department of Obstetrics and Gynaecology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Chylous ascites is an uncommon condition of accumulation of milky fluid rich in lymph and chylomicrons in the peritoneal cavity. Post-surgical complications following dissection near the base of the mesentery, retroperitoneum, or near the cisterna chyli, malignancies (e.g.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!