Chylous ascites as a postoperative complication of a robot-assisted D3 extended right hemicolectomy: a case report

Chylous ascites is the accumulation of lymphatic fluid in the peritoneal cavity due to disruption or obstruction of abdominal lymphatic vessels. It typically presents as painless abdominal distention and is diagnosed by the presence of elevated triglycerides in the ascitic fluid. Although malignancy is the most common cause, abdominal surgery should also be considered in the differential diagnosis. Treatment is primarily conservative and includes a high-protein, low-fat diet with medium-chain triglyceride supplementation. In cases with poor response or contraindications to enteral nutrition, total parenteral nutrition is indicated, reserving surgical intervention for refractory cases. We report a rare case of chylous ascites following a robot-assisted D3 extended right hemicolectomy, successfully managed with conservative therapy.

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Publication Details

Journal
Journal of Surgical Case Reports
Published
2025-08-01
DOI
https://doi.org/10.1093/jscr/rjaf622
Primary Topic
Lymphatic Disorders and Treatments
Type
article
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article

Chylous ascites as a postoperative complication of a robot-assisted D3 extended right hemicolectomy: a case report

Giannella Izamar Llerena Freire, Llerena Freire Luis Francisco
Journal of Surgical Case Reports
Lymphatic Disorders and Treatments
article

Chylous ascites as a postoperative complication of a robot-assisted D3 extended right hemicolectomy: a case report

Giannella Izamar Llerena Freire, Llerena Freire Luis Francisco
article en

Abstract

Chylous ascites is the accumulation of lymphatic fluid in the peritoneal cavity due to disruption or obstruction of abdominal lymphatic vessels. It typically presents as painless abdominal distention and is diagnosed by the presence of elevated triglycerides in the ascitic fluid. Although malignancy is the most common cause, abdominal surgery should also be considered in the differential diagnosis. Treatment is primarily conservative and includes a high-protein, low-fat diet with medium-chain triglyceride supplementation. In cases with poor response or contraindications to enteral nutrition, total parenteral nutrition is indicated, reserving surgical intervention for refractory cases. We report a rare case of chylous ascites following a robot-assisted D3 extended right hemicolectomy, successfully managed with conservative therapy.

Journal of Surgical Case ReportsVol. 2025(8)
Pontificia Universidad Católica del Ecuador (EC), Universidad de Las Américas (EC), Universidad Técnica de Ambato (EC)
Openalex Percentile: Top 67%
Lymphatic Disorders and Treatments
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