Abstract
A 68-year-old woman who had been pointed out having hypercalcemia but had let it alone for about 6 months was seen at the hospital because of nausea and general fatigue. She was admitted for exploration and treatment. From an elevated level of intact PTH level as well as CT and MIBI scintigraphy findings, primary hyperparathyroidism was diagnosed and right lower parathyroidectomy was performed. Oral ingestion was resumed on the first postoperative day, and just then chyle was drained from a drainage tube. Swelling of the neck and dyspnea also appeared, so that the tissue surrounding the chyle leakage was sutured and ligated, and drainage was performed again. Fasting and total parenteral nutrition for 14 days resulted in a decrease in chyle leakage, and the patient started to take a low fat diet. However, large quantities of chyle leak occurred again after initiation of the oral ingestion. Intermittent subcutaneous administration of octreotide acetate was thus carried out. The chyle leakage started to decrease from the second day after the administration and the 7-day administration provided a cure for the patient.
We present this case of chyle leakage causing swelling of the neck in which octreotide acetate was extremely effective, together with a review of the literature.
