간경변 환자에서 위부분절제술 후 발생한 암죽복수 1예
Chylous Ascites in a Patient with Liver Cirrhosis after Subtotal Gastrectomy
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초록
본 저자는 간경변 환자에서 복강경 위부분절제술 후 발생한 이뇨제로 조절 되지 않는 복수를 경험하였고 검사상 수술에 따른 암죽 복수와 간문맥 고혈압으로 인한 복수가 동반된 소견이었다. 이후 저지방식이, 전비경구 영양과 octreotide 병용치료 뒤 암죽복수에서 중성지방 수치 감소하였고 남아있는 간문맥 고혈압에 의한 복수를 이뇨제를 사용하여 조절할 수 있었다. 이후 특별한 재발 없이 호전된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Chylous ascites is the extravasation of milky chyle into the peritoneal cavity. This condition can occur as a result of the disruption or obstruction of the abdominal lymphatics. Abdominal surgery, malignant neoplasms, and cirrhosis can cause chylous ascites. Here, we report a case of intractable ascites caused by chyle leakage and portal hypertension in a patient with alcoholic liver cirrhosis. The ascites occurred following a subtotal gastrectomy to treat stomach cancer and was not resolved with diuretics. Increasing the diuretic dosage was limited by the aggravation of renal function. The ascites was milky in color and analysis showed transudate caused by portal hypertension. Octreotide and diuretic treatments can resolve mixed ascites. In this article, we present the case and review the literature. (Korean J Med 2011;80:449-452)
참고문헌 (20)
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