Chylous Ascites Accompanying Internal Hernia after Total Gastrectomy with Roux-en-Y Reconstruction

Ryota Koyama; Yoshiaki Maeda; Nozomi Minagawa; Toshiki Shinohara; Tomonori Hamada

doi:10.1159/000504565

Chylous Ascites Accompanying Internal Hernia after Total Gastrectomy with Roux-en-Y Reconstruction

Case Rep Gastroenterol. 2019 Nov 21;13(3):481-486. doi: 10.1159/000504565. eCollection 2019 Sep-Dec.

Authors

Ryota Koyama¹, Yoshiaki Maeda¹, Nozomi Minagawa¹, Toshiki Shinohara¹, Tomonori Hamada¹

Affiliation

¹ Department of Gastrointestinal Surgery, Hokkaido Cancer Center, Sapporo, Japan.

Abstract

We report the case of a 69-year-old man with a history of esophagogastric junction cancer (Barrett's esophageal cancer; pT1b [SM], N0, M0, pStage IA) that was surgically resected 2 years prior to the present episode. Recurrence was not observed during follow-up. Following complaints of dysphagia and abdominal pain, computed tomography revealed signs of internal hernia. Thus, laparoscopic exploration was performed. Intraoperatively, accumulation of chylous ascites accompanying the internal hernia through the jejunojejunostomy mesenteric defect was observed, which was successfully treated with laparoscopic hernia reduction and defect closure by sutures without intestinal resection. Here, we discuss the case and report that along with previous studies, our study suggests that chylous ascites might be a reliable sign of intestinal viability for herniated intestines.

Keywords: Chylous ascites; Gastric cancer; Internal hernia; Laparoscopic surgery; Mesenteric defect; Roux-en-Y reconstruction; Total gastrectomy.

Publication types

Case Reports