EP.WE.484Conservative management of post-operative chyle leak after surgery for a large adrenal cavernous haemangioma

Abstract Post-operative chyle leak is a rare but recognised complication after abdominal surgeries particularly those involving dissection adjacent to the retroperitoneal lymph nodes and/or lymphatic systems. There are limited cases of post-operative associated with adrenal surgery reported in literature no consensus on its management. Lymphatics gland drain into thoracic duct via regional or directly cisterna chyli, posterior aorta. If not adequately managed, can be hypovolemia, electrolyte imbalances, malnutrition and immunosuppression. These consequences attributed loss fluid, electrolytes, lipids, proteins, immunoglobulins. We hereby report case 79-year-old male who underwent an open left adrenalectomy, nephrectomy, splenectomy distal pancreatectomy for large, 20.8cm cavernous haemangioma. Chyle was confirmed day 7 based high levels triglycerides output. Intra-operatively there evidence damage. However, major viscera close trunk predisposed patient this complication. The managed conservatively aim decreasing production by dietary manipulation use somatostatin. Enteral nutrition continued strict low-fat diet regular dietician input. strategies contributed gradual resolution patient’s recovery.