# A case report of an unusual presentation of chyle leak after repair of a perforated gastric ulcer

## TL;DR

This paper reports the first case of a chyle leak after an omental patch repair for a stomach ulcer and shows it can be treated without surgery.

## Contribution

The first documented case of chyle leak following omental patch repair for a perforated gastric ulcer.

## Key findings

- Chyle leak occurred after omental patch repair for a perforated gastric ulcer.
- Conservative treatment with low-fat diet and drainage successfully managed the leak.

## Abstract

Chyle leak is an uncommon complication of abdominal surgeries. There are no reported cases of a chyle leakage following an omental patch repair for a perforated gastric ulcer before. A chyle leak from such a case however can successfully be treated conservatively.

We report an unusual case of a 57-year-old male presented with a perforated gastric ulcer who underwent a laparotomy and omental patch repair, which subsequently presented with a chyle leak from his abdominal wound.

Post operative chyle leak usually occurs from the intraoperative disruption of the thoracic duct, cisterna chyli, or major tributaries of the lymphatic system, and hence can also occur following abdominal and retroperitoneal surgeries. Chyle leakage is not one of the known postoperative complications following an omental patch repair. As chyle leak after omental patch repair has not been reported before, we sought to ascertain the causes. This case was successfully treated conservatively. This patient had a low volume chyle leak. The main stay of conservative treatment for a low volume chyle leak is to reduce chyle production via nutrition optimisation. Literature found that a more conservative approach to management of a chyle leak can be very successful. We discuss the conservative management of the chyle leak with intraabdominal drainage and a very low-fat diet.

A chyle leak following an omental patch repair for a perforated gastric ulcer is an unusual post-operative complication. It can be treated conservatively successfully provided the chyle leak maintains at a low volume.

•We report a first case report of a chyle leakage following an omental patch repair for a perforated gastric ulcer.•We discuss the management of the chyle leak with intraabdominal drainage and a very low-fat diet.•It can be treated conservatively successfully provided the chyle leak maintains at a low volume.

We report a first case report of a chyle leakage following an omental patch repair for a perforated gastric ulcer.

We discuss the management of the chyle leak with intraabdominal drainage and a very low-fat diet.

It can be treated conservatively successfully provided the chyle leak maintains at a low volume.