A rare cause of acute abdomen: Chylous ascites

Kaya, Cemal; Yazici, Pınar; Kartal, Kinyas; Bozkurt, Emre; Mihmanlı, Mehmet

doi:10.5152/ucd.2015.2920

Cited by 4 publications

(5 citation statements)

References 10 publications

(10 reference statements)

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“…The accumulation of triglyceride-rich, milky fluid in the peritoneal cavity, as observed in cases of chylous peritonitis, can be attributed to various disorders. These may include abdominal malignancies, cirrhosis, congenital diseases, and postoperative or traumatic causes [ 2 - 4 ]. However, as described in your case, there are instances where no identifiable underlying cause or disease is evident, and this condition is termed “primary chylous peritonitis”.…”

Section: Discussionmentioning

confidence: 99%

“…Acute chylous peritonitis is an uncommon medical condition characterized by the abrupt accumulation of chylous fluid in the peritoneal cavity, which is rich in triglycerides due to the presence of lymph [ 1 ]. This condition usually occurs without any significant underlying pathology, and in over 50% of reported cases, no underlying cause was determined [ 2 ]. However, it is difficult to diagnose preoperatively due to its sudden onset and accompanying acute abdomen signs.…”

Section: Introductionmentioning

confidence: 99%

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Acute primary chylous peritonitis mimicking acute abdomen: a case report and literature review

Zenati,

Jallali,

Korbi

et al. 2024

Pan Afr Med J

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Acute chylous peritonitis is an uncommon medical condition that can occur suddenly, resulting in the buildup of chylous fluid in the peritoneal cavity. It is considered idiopathic because the exact cause is often unknown. The symptoms of acute chylous idiopathic peritonitis can mimic other abdominal emergencies, making it challenging to diagnose and manage, requiring a multidisciplinary approach. We present a case report of acute idiopathic chylous peritonitis miming acute abdomen, how was successfully treated with surgery, and provide a comprehensive review of the available literature on this topic. Chylous peritonitis is a rare condition whose clinical presentation mimics an acute abdomen. It is necessary to undertake careful exploration. An emergent laparotomy is indicated to treat the peritonitis and search for and treat the underlying cause.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute primary chylous peritonitis mimicking acute abdomen: a case report and literature review

Zenati,

Jallali,

Korbi

et al. 2024

Pan Afr Med J

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“…23,24,25,26 Cemal Kaya found no significant difference in portsite infection or hernia between two groups. 27 Ali & Siddiqui 2013 reported discharging sinus following laparoscopic cholecystectomy due to gallstone implantation. 18 All possible efforts should be made to remove spilled gall-stones; however this does not necessitate the conversion to open surgery as these spilled stones are harmful in less than 1%.…”

Section: Discussionmentioning

confidence: 99%

Frequency of port site infection following gall bladder removal through Epigastric vs Umbilical port.

Shaikh¹,

Baloch²,

Shah³

et al. 2021

TPMJ

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Objective: To compare the frequency of port site wound infection following gall bladder removal through umbilical and epigastric port in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Ghulam Muhammad Mahar Medical College, hospital Sukkur. Period: 1st November 2019 to 30th October 2020. Material & Methods: All cases who underwent four port laparoscopic cholecystectomy were enrolled in two groups. All procedures were performed under general anesthesia. As the last event of surgery gall bladder was retrieved in a glove bag through umbilical port in group A and through epigastric port in group B, both under direct camera vision. Wound infection was considered if there was 3 to 5 grade of wound according to Southampton wound grading system (Figure-1) on 5th postoperative day. All demographics and outcome variables were recorded. Results: Age ranged from 20 to 60 years with mean age of 38.875±8.11 years, BMI 29.973±5.12 Kg/m2, duration of surgery 50.656±8.41 mins and Southampton score was 1.044±1.07 in Group A and mean age of 38.560±6.23 years, BMI 27.437±5.04 Kg/m2, duration of surgery 48.920±8.67 mins and Southampton score was 0.856±0.92 in Group B. In group A, 18 (5.7%)patients developed port site wound infection in contrast to 5 (1.6%) patients in group B (P= 0.006). Conclusion: We conclude that epigastric port retrieval of gall bladder following laparoscopic cholecystectomy results in less port site infection.

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“…In this patient, cirrhosis was a possible cause of the chylous ascites, while malignancy and infection were ruled out as secondary causes. Chylous ascites is a rare condition and presents as a secondary to chronic disorders with liver cirrhosis as a causal factor in 0.5% cases [ 3 – 5 ].…”

Section: Discussionmentioning

confidence: 99%

Refractory Chylous Ascites with Chylothorax and an Umbilical Hernia in a Patient Ineligible for a Transjugular Intrahepatic Portosystemic Shunt

Fatah

Audiyanto²

2020

Am J Case Rep

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Patient: Female, 21-year-old Final Diagnosis: Chylous ascites Symptoms: Pitting edema • shortness of breath Medication: — Clinical Procedure: Paracentesis • thoracentesis Specialty: Gastroenterology and Hepatology • General and Internal Medicine • Palliative Medicine Objective: Rare disease Background: Chylous ascites is a rare condition, which is defined by accumulation of a milky fluid due to high triglyceride levels. It is most commonly secondary to malignancy, liver cirrhosis, infection, and tuberculosis. Case Report: A 21-year-old woman from rural Indonesia, came to the hospital with chronic dyspnea and a history of repeated paracentesis. Six years ago, she was diagnosed with chronic hepatitis B. For the past 2 years, she had complaints of progressive dyspnea and increased abdominal swelling. On examination, there was dullness on chest percussion and decreased breath sounds. Shifting dullness was positive on abdominal examination. Paracentesis and thoracentesis were performed and showed high triglyceride levels. She underwent an abdominal computed tomography scan and was diagnosed with liver cirrhosis, complicated with chylous ascites and chylothorax. Repeated paracentesis was performed as a therapeutic approach; she had strict diet guidelines, and was prescribed octreotide, furosemide, spironolactone, and albumin. Despite this treatment, two years later, she developed an umbilical hernia complicated with ulceration. Hernia repair was not possible due to her comorbidities. She was indicated for a transjugular intrahepatic portosystemic shunt (TIPS) for the refractory chylous ascites. However, this could not be performed as the patient could not afford this expensive procedure, which was not covered by insurance. Conclusions: Management of refractory chylous ascites is challenging, especially in underdeveloped countries due to socioeconomic problems and limited health care facilities. Although TIPS is indicated in refractory chylous ascites, repeated paracentesis can be useful as an alternative method.

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A rare cause of acute abdomen: Chylous ascites

Cited by 4 publications

References 10 publications

Acute primary chylous peritonitis mimicking acute abdomen: a case report and literature review

Acute primary chylous peritonitis mimicking acute abdomen: a case report and literature review

Frequency of port site infection following gall bladder removal through Epigastric vs Umbilical port.

Refractory Chylous Ascites with Chylothorax and an Umbilical Hernia in a Patient Ineligible for a Transjugular Intrahepatic Portosystemic Shunt

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