LYMPHATICOVENOUS SHUNT FOR THE TREATMENT OF CHYLOUS REFLUX BY SUBCUTANEOUS VEIN GRAFTS WITH VALVES BETWEEN MEGALYMPHATICS AND THE GREAT SAPHENOUS VEIN: A CASE REPORT

Chylous reflux is a rare disorder in which chyle flows antidromically from its normal route to the extremities, thorax, abdominal cavity, or other parts of the body. We present a case of chylous reflux with megalymphatics in a 28-year-old boy who presented chylorrhea in the foot, leg, and external genitalia, lymphedema, and hemangioma in the affected limb. Lymphaticovenous shunts using subcutaneous vein grafts with valves were applied to the patient for treatment of repeated chylorrhea. After surgery, the patient has not complained of chylorrhea and been freed from conservative physiotherapy such as bandaging or application of compression stockings for lymphedema for two years. A subcutaneous vein graft with valves may be considered a useful method as a shunt between incompetent and dilated lymphatics and veins instead of a saphenous vein graft in the treatment of chylous reflux in lower extremities. We discuss these treatments based on the literature about chylous disorders. (C) 2010 Wiley-Liss, Inc. Microsurgery 30:553-556, 2010.