Treatment of post-traumatic chyluria with subcutaneous octreotide administration.
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We report a case of acute chylous ascites secondary to acute biliary pancreatitis, the first such case reported in the literature. Surprisingly, chylous ascites was detected during elective cholecystectomy. The pathogenesis and management of this problem is discussed.
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Chylous ascites may follow operative injury to retroperitoneal lymphatics. When possible, early reoperation has been advised. This report describes a patient with chylous ascites following emergency abdominal aortic aneurysmectomy. Because the patient was not a candidate for reoperation, total parenteral hyperalimentation was employed in management. This approach resulted in a successful outcome.
Chyluria is a urologic manifestation of a lymphatic system disease abnormality and leads to nutritional deficiency. The case of a patient with chyluria is presented, and the results of lymphoscintigraphy with those of contrast lymphangiography are compared. Lymphoscintigraphy very clearly showed the site of the fistulae and was as precise as lymphangiography. Follow-up lymphoscintigraphy 2 months after therapy revealed no radionuclide accumulation. Lymphoscintigraphy is a useful, noninvasive, safe, and simple technique for the diagnosis and follow-up of chyluria.
Chylous leakage from the thoracic duct into the pleural space may occur after any type of thoracic surgery; however, there are few reports of this condition after coronary artery bypass grafting. A case of chylothorax after combined coronary bypass and mitral valve replacement is reported to illustrate a discussion of its pathologic basis, diagnosis and management.
The CT findings of a noncommunicating duplication cyst associated with the large intestine and a chylous cyst of the mesentery are presented. Although these are rare entities, CT findings may suggest the diagnosis by demonstrating peristaltic movement in a duplication cyst and a fat-fluid interface in a chylous cyst.
A patient, who proved to have a chylous cyst of the colon, presented with bright red rectal bleeding and an abnormality on barium enema suggesting a colonic polyp. We review such an unusual presentation and other reported cases.
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Study of a patient with traumatic chylothorax after blunt chest trauma defines the changes in cellular immunocompetence during nonoperative management and emphasizes the importance of defining these parameters in addition to documenting the effects of metabolic deterioration.
PURPOSE: We report our experiences treating 5 patients who had filarial chyluria using an endoscopic approach. MATERIALS AND METHODS: Two men and 3 women 47 to 83 years old with chyluria were treated with endoscopic coagulation using guide tube methods. Intrarenal pelvic instillation of silver nitrate was not effective in 4 patients and catheterization was impossible in 1. RESULTS: The responsible lesion was successfully coagulated in all 5 patients. Because the lesion was in the ruptured portion of the caliceal fornix, we thought that chyluria had arisen in the fragile portion of the fornix (fistulization). After endoscopic treatment there was no recurrence in any patient. CONCLUSIONS: Endoscopy is effective and minimally invasive therapy for filarial chyluria.
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A patient never exposed to filarial parasites presented with intermittent chyluria and was found to have coincidental pelvic lipomatosis. The pathophysiology of chyluria and pelvic lipomatosis are reviewed and their possible relationship in the present case is discussed.
We have described the occurrence of isolated chylopericardium associated with lymphocytic lymphoma in remission. The effusion may have been related to previous mediastinal lymphoma. Further, pericardial and mediastinal exploration for pericardial effusion represents appropriate treatment of patients with malignancies in whom preliminary studies fail to demonstrate conclusive evidence of residual neoplasm.