Abstract
We report a case of chyloperitoneum following resection of esophageal carcinoma in which somatostatin analogue might be effective.
A 57-year-old male patient with middle-upper intrathoracic esophageal carcinoma underwent esophagectomy by right thoracolaparotomy. Retrosternal reconstruction using gastric tube, cervical end-to-end anastomosis, and cervico-thoraco-abdominal lymph node dissection. His postoperative course was uneventful. On the 9th postoperative day, he started to take oral ingestion. He became to have a sense of fullness from 14th day. A large quantity of chylous fluid in the peritoneal cavity was recognized by intraperitoneal aspiration and the diagnosis of chyloperitoneum was comfirmed by lymphoscintigraphy. By a conservative treatment subjective symptoms were improved, then he restarted to take oral ingestion from 40th day, but the subjective symptoms gradually got worse. He stopped to take oral ingestion on 50th day, however, no symptomatic remission was attained. Finally administration of somatostatin analogue was started on 60th day. After administration of somatostatin analogue, abdominal distention, enlarging girth and disproportionate weight gain gradually disappeared. He was discharged from the hospital on 103rd day.
We conclude that somatostatin therapy should be attempted against intractable chylous effusion following operation before considering surgical intervention.
