Acute abdomen by chylous ascites secundary to acute pancreatitis: a case report

Chylous ascites (CA) is a rare condition, and it can present as a peritoneal reaction named acute chylous peritonitis (ACP). We report the case of a 26-year old male who developed acute abdomen. He underwent surgery and turbid milky fluid was found in his abdominal cavity. A prophylactic appendectom...

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Bibliographic Details
Authors: Vera-Portilla, Angel F., Arenas Ramirez, Raúl, Quispe Ala, Pedro, Vera-Portilla, Walter, Galdos, Jose Luis, Cornejo Valencia, Darling
Format: article
Status:Published version
Publication Date:2021
Country:Perú
Institution:Colegio Médico del Perú
Repository:Acta Médica Peruana
Language:Spanish
OAI Identifier:oai:amp.cmp.org.pe:article/2074
Online Access:https://amp.cmp.org.pe/index.php/AMP/article/view/2074
Access Level:Open access
Keyword:Abdomen agudo
Ascitis quilosa
Quiloperitoneo
Peritonitis quilosa aguda
Pancreatitis aguda
Acute abdomen
Chylous ascites
Chyloperitoneum
Acute chylous peritonitis
Acute pancreatitis
Description
Summary:Chylous ascites (CA) is a rare condition, and it can present as a peritoneal reaction named acute chylous peritonitis (ACP). We report the case of a 26-year old male who developed acute abdomen. He underwent surgery and turbid milky fluid was found in his abdominal cavity. A prophylactic appendectomy was performed, as well as aspiration and lavage of the abdominal cavity. Drainage tubes were placed. Studies of the fluid revealed increased triglyceride and amylase contents. Gram-staining and cultures were negative. A computed tomography scan revealed acute pancreatitis (Balthazar C), so a diagnosis of chylous ascites secondary to pancreatitis was confirmed. The patient did well, he received hydration, analgesics, and oral diet according to tolerance. Very few cases of ACP have been reported in the literature, and its association with acute pancreatitis is very unusual. This condition may resemble surgical acute abdomen, and its management includes surgical exploration with peritoneal drainage. Nutritional support may also be needed.