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Treatment of Iatrogenic Chyloretroperitoneum with Octreotide Following Spinal Deformity CorrectionA Case Report
Dan Dixon, MD1; Jeffrey Cassidy, MD2
1 Grand Rapids Medical Education Partners/Michigan State University Department of Orthopedics, 300 Lafayette SE, Suite 3400, Grand Rapids, MI 49503. E-mail address: daniel.dixon@grmep.com
2 Department of Pediatric Orthopaedics, Helen DeVos Children’s Hospital, 1425 Michigan Street NE, Grand Rapids, MI 49503. E-mail address: Jeffrey.Cassidy@spectrumhealth.org
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Investigation performed at Naval Medical Center, San Diego, California

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Jun 26;3(2):e61 1-4. doi: 10.2106/JBJS.CC.L.00208
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Chylous fluid leakage is a rare but well-described complication of anterior spinal surgery1-6. Conservative treatment, including a drainage tube and a low-fat diet or total parenteral nutrition supplemented with oral medium-chain triglycerides, has had varying success. Treatment is often prolonged, requiring continuous drainage for up to six months in some reported series7. The use of octreotide, a somatostatin analogue, was first described in the general surgery literature for the treatment of chylothorax resulting from a ruptured thoracic duct2,4,5. Numerous reports have confirmed the success of octreotide in the treatment of chylous accumulations in the chest, peritoneal cavity, and retroperitoneum, although, to the best of our knowledge, there is no mention of its use in the orthopaedic literature. We report a case of chyloretroperitoneum following lumbar hemivertebrectomy that was successfully treated with octreotide. The patient and his parents were informed that data concerning the case would be submitted for publication, and they provided consent. No patient identifiers were used in the course of this investigation in accordance with Health Insurance Portability and Accountability Act regulations.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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