%0 Journal Article
%T Chylous ascites following radical nephrectomy: a case report
%A Shahzad S Shah
%A Kamran Ahmed
%A Richard Smith
%A Ravi Mallina
%A Pouya Akhbari
%A Mohammad S Khan
%J Journal of Medical Case Reports
%D 2008
%I BioMed Central
%R 10.1186/1752-1947-2-3
%X We report the first case of chylous ascites following radical nephrectomy for a renal cell carcinoma involving the right half of a crossed fused renal ectopia. The patient was managed conservatively.Post-operative chylous ascites is a rare complication of retroperitoneal and mediastinal surgery. Most cases resolve with conservative treatment which aims at decreasing lymph production and optimizing nutritional requirements along with palliative measures. Refractory cases need either open or laparoscopic ligation of the leaking lymphatic channels. A review of the current literature on the management of post-operative chylous ascites is presented.Chylous ascites results from either blockage of the lymphatics or leakage secondary to inadvertent trauma during surgery. Most cases of traumatic chylous ascites resolve with conservative treatment but refractory cases may need surgical ligation of lymphatics. We report the first reported case of chylous ascites following radical nephrectomy for a renal cell carcinoma involving the right half of a crossed fused renal ectopia. The chylous ascites resolved with conservative management. A brief review of the literature on the management of post-operative chylous ascites is presented.A 60-year old male presented with acute right loin pain and frank haematuria. He was hypertensive but well controlled on medication. He had undergone coronary artery bypass grafting 9 years earlier. Physical examination was normal apart from a median sternotomy scar. Urine was sterile on culture and showed no malignant cells on cytology. Urea, creatinine and electrolytes were within normal range. Ultrasound scan showed no kidney in the left renal area and a 7 กม 5 กม 5 cm heterogenous irregular mass arising from the mid-pole of the right kidney. CT scan confirmed the presence of a large complex mass measuring 11.6 กม 8 กม 6.5 cm arising from the mid and upper pole of the right kidney. In addition it showed a cross fused left kidney in the right iliac foss
%U http://www.jmedicalcasereports.com/content/2/1/3