Marfan症候群患者の開胸腹部大動脈瘤修復術後に発症した腹水

Chylous Ascites Developing after Open Thoracoabdominal Aortic Aneurysm Repair in a Patient with Marfan Syndrome.

• Hakan Kara

抄録

腹水は、リンパ腫、転移性悪性腫瘍、腹部手術などにより腹膜腔内に病的に蓄積した腹水であるが、まれにシテルナシリーやその主要枝の手術外傷によるものもある。Marfan症候群の既往歴を持つ24歳男性が腹部膨満感，腹痛，切開部の体液，脱力感を訴えて当院に来院した．9日前に胸腹部大動脈瘤の選択的開腹大動脈瘤修復術を受けていた．腹腔内に大量の体液が溜まっていることがCTで確認され，外科的にドレナージされた．腹水は腹水と診断され，保存的治療を経て退院した．

Chylous ascites is the pathologic accumulation of chylous fluid in the peritoneal cavity, caused by lymphomas, metastatic malignancies, and abdominal surgeries, rarely due to surgical trauma of the cisterna chyli or its major branches. A 24-year-old man with history of Marfan syndrome presented to our hospital with abdominal distention, abdominal pain, fluid in the incision region, and weakness. He had underwent an elective open aneurysm repair surgery nine days before for thoracoabdominal aortic aneurysm. Computed tomography revealed massive fluid collection in the abdominal cavity, which was drained surgically. He was diagnosed with chylous ascites and was discharged after conservative treatment.