PDF(Pubmed)
Abstract：
BACKGROUND Chylous ascites (chyloperitoneum), a condition arising from lymphatic leakage in the peritoneal cavity, is rare in liver cirrhosis patients, accounting for less than 1% of cases. Treatment typically involves therapeutic paracentesis, dietary modifications, a low-fat, high-protein diet, and medium-chain triglyceride (MCT) supplementation. Orlistat, a fat absorption inhibitor, has been reported to show potential efficacy in treating chylous ascites. CASE REPORT We detail the case of a 59-year-old male patient admitted for decompensated liver disease and worsening ascites. Diagnostic paracentesis identified chylous ascites, indicated by a 3.5 mmol/L triglyceride level. Despite administering therapeutic paracentesis, dietary modifications, MCT supplementation, Spironolactone, and Terlipressin for a presumed hepatorenal syndrome, the patient\'s ascites remained chylous for two weeks. On administering orlistat, a significant reduction in ascites volume and chylous content was observed, with triglyceride levels dropping to 0.7 mmol/L. CONCLUSIONS Our case illustrates the potential of orlistat in managing chylous ascites in liver cirrhosis patients, marking only the second such case reported in the existing literature. It encourages further exploration of orlistat\'s therapeutic potential in treating chylous ascites.
摘要：
背景乳糜腹水（乳糜腹膜），由腹膜腔淋巴渗漏引起的疾病，在肝硬化患者中很少见，占不到1%的病例。治疗通常包括治疗性穿刺，饮食调整，低脂肪，高蛋白饮食,和中链甘油三酯（MCT）补充。奥利司他,脂肪吸收抑制剂,据报道，在治疗乳糜腹水方面显示出潜在的疗效。案例报告我们详细介绍了一名59岁男性患者因失代偿性肝病和腹水恶化而入院的情况。诊断性穿刺发现乳糜腹水，由3.5mmol/L甘油三酯水平表示。尽管进行了治疗性穿刺,饮食调整，MCT补充剂，螺内酯,和特利加压素用于推测的肝肾综合征，病人的腹水持续两周保持乳糜状态。在服用奥利司他时，观察到腹水体积和乳糜含量显着减少，甘油三酯水平降至0.7mmol/L结论我们的案例说明了奥利司他在治疗肝硬化患者乳糜腹水方面的潜力，仅标记现有文献中报告的第二例此类病例。它鼓励进一步探索奥利司他治疗乳糜腹水的治疗潜力。
