Chylous ascites following abdominal aortic replacement surgery is a rare complication with incidence rates ranging from 0.03% to 0.1% and treatment that has not yet been established. As a conservative treatment, a fat-restricted diet, complete intravenous nutrition, and abdominal puncture are reportedly performed. Moreover, octreotide and etilephrine, which are somatostatin analogs, are also administered. We report a case of chylous ascites following vascular replacement of an inflammatory abdominal aortic aneurysm. Although oral intake was resumed from the third day following the operation, the contents of the drain changed to white turbidity from the next day, and the triglyceride value in the drainage was high. Chylous ascites was diagnosed, and conservative treatment was initiated. No improvement was observed despite conservative treatment; however, it responded to embolization with N-butyl cyanoacrylate and administration of diuretics without additional surgical procedures.
Kawada et al. (2024) studied this question.