Clinical analysis of postoperative complicated chylous ascites of cavernous transformation of portal vein in children

Abstract

Objective To analyze the cause,prevention and therapy of postoperative complicated chylous ascites of cavernous transformation of portal vein in children.Methods Between Jan.2001 and Apr.1 2006.9 patients(male 5,female 4)who had recurrent upper gastrointestinal hemorrhage caused by cavernous degeneration of portal vein were operated and analyzed retrospectively.Their age ranged from 2yr7mon to 12yr2mon with an average of 7yr3mon.Four patients had complicated postoperative chylous ascites.Of them,2 cases were performed on splenectomy and splenorenal shunt,1 was received side-to-side mesocaval shunt and 1 had distal splenorenal shunt.Results Three of the 4 patients were cured after short-term fasting and total parental nutrition(TPN)administrated for 1-4 weeks.One case had accumulating ehylus aboUt 2000 ml daily after 4 weeks of conservative treatment,and the chylus was discharged one week after a peritoneo-saphenous shunt. An patients were followed-up from 1 year to 6 years without recurrence.Conclusions The cause of postoperative complicated chylous ascites of cavernous transformation of portal vein in children is the damaging of lymphatic vessels and the chylocyst during operation.Conservative therapy is effective,whereas an operation is chosen if necessary. Key words: Chylous ascites; Portal vein