Abstract

LOPEZ OTERO, Mª J. et al. Neck chylous fistula: conservative treatment. Nutr. Hosp. [online]. 2010, vol.25, n.6, pp.1041-1044. ISSN 1699-5198.

Injury to the thoracic duct, leading to chyle leak, occurs in 1-2,5% of patients who undergo neck dissection. Associated complications include malnutrition, immune compromise, fistula formation and carotid blowout. No definitive treatment algorithm can be deduced from the current literature, but on last reviews, there is an agreement on the conservative management. Medical management is based on that decreasing chyle flow will allow for spontaneous closure of the chyle leak. Conservative treatment includes: closed vacuum drainage, bed-rest, nutrition modification and synthetic somatostatin analog. Nutrition modification involves a low-fat diet supplemented with medium-chain triglycerides (MCT), enteral nutrition with high percentage of MCT or parenteral nutrition.

Keywords : Chylous fistula; Neck dissection; Mediumchain triglycerides; Somatostatin analog.

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