KMID : 1164620220550010081
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Korean Journal of Thoracic and Cardiovascular Surgery 2022 Volume.55 No. 1 p.81 ~ p.84
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Treatment of Refractory Chylous Ascites with an Innovative Peritoneovenous Shunt: Temporary Usage of a Continuous Renal Replacement System: A Case Report
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Park Ji-Youn
Lee Jae-Jun Lee Jung-Hee Shim Young-Mog
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Abstract
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Esophagectomy and esophageal reconstruction are commonly chosen as surgical options for esophageal cancer. However, prolonged untreated chyle leakage is associated with a poor prognosis. We report the case of a patient with refractory chylous ascites. To limit the ongoing fluid loss, we utilized the chylous ascites as an additional fluid source in a renal replacement therapy system. A continuous renal replacement therapy (CRRT) drainage system was modified to drain both the chylous ascites and venous blood. The ascites drainage rate was determined empirically and regulated by a dial-flow extension set. The CRRT mode was set to continuous venovenous hemodiafiltration and maintained for 7 days. After the patient was weaned from CRRT, ascites did not reaccumulate, and the patient¡¯s general condition improved dramatically. No infections related to the system occurred. This procedure temporarily alleviates symptoms and provides more time for alternative treatment strategies.
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KEYWORD
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Chylous ascites, Chylothorax, Peritoneovenous shunt, Esophageal neoplasms, Continuous hemodiafiltration shunt, Case report
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