Surgery>>>>>Small Intestine
Question 22#

A patient with recent onset of ascites after an episode of acute pancreatitis undergoes paracentesis, which reveals cloudy white fluid. What therapy is indicated?

a. Surgical exploration
b. Low-fat diet
c. Total parenteral nutrition (TPN) and octreotide
d. Octreotide and weekly paracentesis

Correct Answer is C


Chylous ascites can develop as a complication of operative procedures or inflammatory conditions such as acute pancreatitis. Lymphatic drainage from damaged lymphatics can heal when the patient is made NPO, and maintained on TPN and octreotide. Medium-chain triglycerides have been advocated as an oral diet, but temporary cessation of oral feeding and octreotide comprise the most successful therapy.