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Milking the System: Dietary Therapy of Post-nephrectomy Chylous Ascites

  • Anas GremidaEmail author
  • Christopher Atkinson
  • Glenda Lopez-Portillo
  • Archana Kaza
  • Denis McCarthy
UNM CLINICAL CASE CONFERENCES
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Case Report

A 73-year-old Hispanic male was initially evaluated for abdominal distention of 18 months duration, which had started following laparoscopic nephrectomy for a left renal mass, whose pathologic examination revealed to be clear cell carcinoma, without evidence of metastasis. The patient had had no abdominal distention or ascites prior to the surgery. Abdominal distention, first noticed 4 weeks after his nephrectomy, was accompanied by symptoms that included a sense of heaviness, bloating, and loss of appetite. Physical examination revealed the presence of ascites that required multiple therapeutic paracenteses monthly for symptom relief. The patient had no history or any risk factors for cirrhosis or cardiac failure.

Physical examination showed a normal appearing, healthy male. Frank’s sign was noted on both earlobes. No jugular venous distention or V-wave was noted, and cardiac and pulmonary examinations were otherwise normal. The abdomen appeared distended with fullness in...

Keywords

Ascites Chylous ascites Chyloperitoneum Cisterna chyli Somatostatin Octreotide Retroperitoneal Medium-chain triglycerides Total parenteral nutrition (TPN) 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Anas Gremida
    • 1
    Email author
  • Christopher Atkinson
    • 1
  • Glenda Lopez-Portillo
    • 2
  • Archana Kaza
    • 1
  • Denis McCarthy
    • 1
  1. 1.Division of Gastroenterology and HepatologyUniversity of New Mexico School of Medicine Medical CenterAlbuquerqueUSA
  2. 2.Department of Internal MedicineUniversity of New Mexico School of Medicine Medical CenterAlbuquerqueUSA

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