A patient with liver cirrhosis stage hepatitis C having hepatocellular carcinoma and cervical cancer of the uterus treated by octreotide for chylous ascites

Abstract

A 77-year-old woman was admitted to our hospital for worsening abdominal fullness. She had liver cirrhosis stage hepatitis C that was complicated with hepatocellular carcinoma, for which she had received RFA, PEIT, and five courses of TACE, as well as cervical cancer of the uterus with lung metastases that had been treated surgically. We detected chylous ascites and elevated ascites triglyceride (TG) of 506 mg/dl, for which she was commenced on a fat-restricted diet and administered octreotide at 300 μg/day for one week. Her abdominal distention showed improvement and ascites TG decreased to 146 mg/dl. She was later transferred following another course of octreotide therapy. Chylous ascites is a rare complication caused by lymphatic fluid congestion due to obstruction of the lymphatic system that may result in serious nutritional and immunological complications. Clinicians should consider octreotide in addition to diet modification when treating patients with this condition. © 2013 The Japan Society of Hepatology.