Abstract
A patient with intractable chyloperitoneum was successfully treated with octreotide, a somatostatin analogue. The patient was a 65-year-old man. A persistent chyloperitoneum developed as a complication after an abdominal aorta to bilateral femoral artery bypass with a bilateral femoro-popliteal bypass due to obstructive atherosclerosis. Dietary therapy with a fat-free diet had been continued for 11 days but the lymphorrhea did not diminish. A surgical ligation of a lymph channel around the abdominal aorta was performed via a re-laparotomy on the 12th postoperative day and fasting therapy under intravenous hyperalimentation was induced, however, the lymphorrhea persisted. Finally, octreotide was administered on the 15th postoperative day. The lymphorrhea decreased dramatically thereafter and the chyloperitoneum disappeared after 11 days of the octreotide treatment. Octreotide is therefore considered to be an effective therapy for chyloperitoneum and its early administration should shorten the therapeutic period.
