A Case Report of Intractable Ascites Due to Hepatic Lymphorrhea from Hepatoduodenal Ligament after Radical Gastrectomy for Gastric Cancer

Hirofumi Ota, Tomoko Miyazawa, Inaba Hiizu, Nobuhisa Ueda, Yoshiichi Maeura, Seiichi Matsunaga, Kazuyoshi Tomita

Department of Surgery, Shinsenri Hospital

A very rare case of intractable ascites due to hepatic lymphorrhea following radical gastrectomy for gastric cancer is reported. A 70-year-old man had an operation for gastric cancer in another hospital. Massive ascites appeared soon after surgery. Diuretics and paracentesis failed to decrease the ascites. The quality of the ascites strongly suggested it was caused by lymphorrhea from injured hepatic lymph channels. Exploratory laparotomy was performed and the damaged lymph vessels in the hepatoduodenal ligament were ligated. He has had no more retention of ascitic fluid over one year after the operation. The hepatic lymphorrhea after abdominal surgery usually disappeared spontaneously in a short time. However in a case of intractable ascites following radical gastrectomy, which might be caused by hepatic lymphorrhea, surgical treatment should be considered before the patient gets worse.

Key words
hepatic lymphorrhea after gastrectomy for gastric cancer, intractable ascites

Reprint requests
Hirofumi Ota Department of Surgery, Shinsenri Hospital
1-1-D6 Tsukumodai, Suita City, 565 JAPAN

Accepted
December 9, 1992

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