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Review
. 2021 Jul;103(7):e231-e233.
doi: 10.1308/rcsann.2020.7112.

Chyle leak following total colectomy for ulcerative colitis: a case report and review of the literature

C F Brewer  1 , Y Al-Abed  1
Affiliations
Review

Chyle leak following total colectomy for ulcerative colitis: a case report and review of the literature

C F Brewer et al. Ann R Coll Surg Engl. 2021 Jul.

Abstract

Chyle leak is a rare complication in colorectal surgery. It occurs due to disruption of the lymphatic drainage network in the abdomen or retroperitoneum. We describe the first reported case of chyle leak following total colectomy for inflammatory bowel disease. Our patient underwent total colectomy for severe ulcerative colitis not responsive to medical treatment. Four days postoperatively, a milky fluid was noted in the drainage bag. Analysis of the fluid confirmed chyle. The patient remained well and was successfully managed conservatively with a fat-free elemental diet and was discharged from hospital on day 12 postoperatively. A review of the literature suggests that conservative management with dietary modification is a common and effective management strategy; however, medical and surgical options exist for refractory cases.

Keywords: Chyle leak; Chylous ascites; Elemental diet; Total colectomy; Ulcerative colitis.

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Figure 1
Pelvic drain, postoperative day 4
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