Ertuğrul Gazi ALKURT, Furkan UĞUR, Veysel Barış TURHAN, Bahadır KARTAL, Muhammet Halil DURU, Murtaza Salih KEPEZ
Acta Haematologica Oncologica Turcica - 2026;59(1):56-58
Chyle fistula is a rare but potentially serious complication that can occur after head and neck surgeries such as thyroidectomy and neck dissection. Conservative approaches are recommended as the first-line treatment, particularly for high-output lymphatic leaks following lateral neck dissection. This case report presents the successful conservative management of a high-output chyle fistula in a young female patient who previously underwent thyroidectomy and neck dissection due to recurrent papillary thyroid carcinoma. On postoperative day 3, chylous drainage of 1200 mL was observed, and octreotide therapy (100 µg three times daily, total 0.3 mg/day) was initiated. On day 5, oral intake was discontinued and total parenteral nutrition was started. During follow-up, a significant reduction in drainage was noted; serum albumin and total protein levels were monitored, and albumin supplementation was administered. Oral intake was reintroduced on day 12, and the patient was discharged on day 14 without complications or drainage. This case demonstrates that high-output lymphatic leaks can be successfully managed without surgical intervention through early diagnosis and appropriate conservative treatment.
