Archives of Head and Neck Surgery
https://archivesheadnecksurgery.com/article/doi/10.4322/ahns.2018.0943
Archives of Head and Neck Surgery
Case Report Neck Dissection

High-output chyle fistula treated with octreotide after neck dissection for papillary thyroid carcinoma

Felipe Toyama Aires, Felipe Augusto Brasileiro Vanderlei, Raquel Ajub Moyses, Claudio Roberto Cernea, Marcos Roberto Tavares

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Abstract

Chyle fistula is a relatively rare complication of neck dissection occurring in about 2-3% of cases; it is associated with increased morbidity and mortality. The use of somatostatin analogs (octreotide) is well documented in cases of pancreatic and enterocutaneous fistulas. In fistulas after neck dissections, it is based on few reports and case series. The aim of this study was to report a case of conservative control of high-output fistula with octreotide. A 34-year-old female underwent total thyroidectomy with neck dissection (central compartment and left II-V levels). Postoperatively, she developed high-output lymphatic fistula (>1,600 mL/day). Fistula flow remained high in spite of conservative measures. We opted for prescription of octreotide 0.1 mg subcutaneous every 8 hours and observed complete improvement of the fistula after three days.

Keywords

chyle; fistula; neck dissection; octreotide.

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