Reza Alizadeh Kashani - FCCM, Assistant Professor, Clinical Research Development Unit, Shahid Madani, Educational & Medical Center, Alborz University of Medical Sciences, Karaj, Iran
Sevak Hatamian - FCCM, Assistant Professor, Clinical Research Development Unit, Shahid Madani, Educational & Medical Center, Alborz University of Medical Sciences, Karaj, Iran
Leila Hajmaghsuodi - General surgeon, Assistant Professor, Clinical Research Development Unit, Shahid Madani Educational& Medical Center, Alborz university of Medical Sciences, Karaj, Iran
Nazanin Nourian - BScN, Clinical Research Development Unit, Shahid Madani, Educational & Medical Center, Alborz University of Medical Sciences, Karaj, Iran
Nadia Fathi Madarsaraei - BScN, Clinical Research Development Unit, Shahid Madani, Educational & Medical Center,Alborz University of Medical Sciences, Karaj, Iran

Introduction Chylous ascites is a rare form of ascites. The most common causes of Chylous ascites are abdominal malignancy (especially lymphoma). Chylothorax is a rare cause of a large pleural effusion. In about 18% of the cases of chylothorax, lymphoma is the underlying cause. Octreotide is similar in action to somatostatin, but selectivity is superior and has longer half-life. Octreotide is recommended for reduction of lymphatic flow. Patient presentation:A 57 years old cachectic woman presented with ascites and huge left side pleural effusion. she underwent exploratory laparotomy where few biopsies were taken from peritoneum and mesenteric lymph nodes and the patient transferred to ICU with a peritoneal drain and left side chest tube. In ICU, PPN was started for the patient (Aminoacid 10%,Intralipid 10%,D/W 50%).During first 10 days ICU admission, there were chylous secretions in both abdominal drain and chest tube, approximately 1500-2500ml and 250-500ml respectively. With administrating 100 μg Octreotide every 8 hours subcutaneously, chylous secretions begun to decrease from chest tube and abdominal drain after 24 hours.After 72 hours chylous secretions were less than 100 ml per day from both routes. Pathology reports follicular lymphoma grade II from biopsies and the patient transfer to Oncology service for proper treatment.Discussion There were some reports of using Octreotide (IV infusion or Subcutaneous) for ceasing of chylothorax after midline sternotomy in thorax surgeries. Administrating Octreotide seems beneficial in conservative treatment of chylous ascites and chylothorax due to lymphoma.

chylothorax, chylous ascites, lymphoma, octreotide