We report an uncommon case of idiopathic acute chylous peritonitis mimicking an acute appendicitis in a 30-year-old female patient with a 2-day history of abdominal pain, nausea and vomiting. Chylous ascites is a rare form of ascites characterized by the presence of a milky fluid rich in triglycerides. It occurs as a result of a damage to the lymphatic system due to trauma or other benign and malignant pathologies. Although the most common clinical presentation is progressive painless abdominal distension, less frequently it can cause acute abdomen symptoms. The management is based on identifying and treating the underlying pathology. Aspiration of the fluid and drainage are the only therapy required if a clinically diagnosis cannot be made. Surgical laparoscopic exploration is necessary to make a diagnosis and to treat effectively acute abdomen cases.In the absence of a significant determining pathology, we talk about idiopathic chylous peritonitis. KEY WORDS: Chylous ascites, peritonitis, laparoscopy.
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J Minim Invasive Gynecol
December 2024
Department of Gynecology, The Second People's Hospital of Guiyang, Guiyang, China.
Radiol Case Rep
February 2025
Department of Urology Surgery, Hanoi Medical University Hospital, No1, Ton That Tung, Dong Da, Hanoi, Vietnam.
Postoperative chylous ascites is a rare complication following retroperitoneal surgeries, presenting significant challenges in diagnosis and management. Retroperitoneal cyst surgery resulting in chylous leaks is an uncommon complication that has not been previously reported in the literature. Therefore, we report a clinical case of postoperative chylous ascites following retroperitoneal cyst removal with underlying idiopathic thoracic duct obstruction.
View Article and Find Full Text PDFUrol Case Rep
November 2024
Department of Urology, Emory University School of Medicine, Atlanta, GA, USA.
Extra-adrenal, functional paraganglioma, if not medically controlled, requires early surgical resection. This can often be challenging when found in a retroperitoneal location, where resections are prone to lymphatic disruption and chyle leaks. Chylous ascites carry a significant risk of protein and caloric malnutrition, dehydration, and even mortality given the nutrient-rich characteristic of lost lymphatic fluid.
View Article and Find Full Text PDFCureus
November 2024
Department of Thoracic Surgery, Tenri Hospital, Tenri, JPN.
Chylous ascites, a rare but severe complication of abdominal surgery, often results from lymphatic vessel damage during procedures, such as extended resection and lymphadenectomy. Although conservative management through dietary modifications and medications is the primary approach, refractory cases may lead to severe complications including nutritional deficiencies and even death. Herein, we report a case of refractory chylous ascites that progressed to chylothorax after extended right hepatectomy with lymph node dissection for intrahepatic cholangiocarcinoma.
View Article and Find Full Text PDFCurr Probl Surg
December 2024
Department of General Surgery, Dow University of Health Sciences, Karachi 74200, Pakistan.
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