A Rare Complication of Chylous Leak After simple Nephrectomy. A case report

Abstract

Background: Chylous leakage results from either blockage of the lymphatics or leakage secondary to inadvertent trauma during surgery. Most cases of traumatic chylous leakage resolve with conservative treatment but refractory cases may need surgical ligation of lymphatics. A 38 years old female patient presented with unbearable left loin pain. The patient has neither past medical history nor surgical history. No abnormalities were detected regarding the general and abdominal examination with average body mass index. Laboratory investigations were within normal values. Ultrasound imaging of the abdomen and pelvis showed left hydronephrotic kidney with thinned out parenchyma (bag of water) further imaging was done. Non contrast computed tomography (NCCT) abdomen and pelvis showed left hydronephrotic kidney.We report a rare case of chylous leak after simple nephrectomy for a poorly functioning kidney. The patient was managed conservatively by using a betadine solution instillation through the tube drain of the operation then closing the drain for 24 hours. Conclusion: Post-operative chylous leak is a rare but considerable complication of retroperitoneal surgery. Most cases resolve with conservative treatment. Refractory cases need either open or laparoscopic ligation of the leaking lymphatic channels.