Chylous ascites following resection of a ruptured abdominal aneurysm. Treatment with a peritoneovenous shunt.

The development of chylous ascites after an abdominal surgical procedure is potentially grave. It frequently leads to malnutrition and significant mortality. Chylous ascites developed after emergency repair of a ruptured abdominal aneurysm. In spite of treatments with low-fat diet (medium-chain triglycerides), hyperalimentation, and abdominal paracentesis, hypoproteinemia and peripheral edema developed and symptomatic ascites continued. Though some success has been reported following ligation of leaking lymphatics, we avoided laparotomy because the patient was recovering from formidable complications. A peritoneovenous shunt was placed. No complications occurred and permanent recovery promptly resulted. We believe this is a reasonable alternative to laparotomy.