Sit-ups and emergency abdominal surgery: a rare case of intestinal volvulus and resultant chylous ascites incited by abdominal exercises

Gritsiuta, Andrei I.; Bracken, Alexander; Lara-Gutiérrez, Jorge; Gilleland, William

doi:10.1093/jscr/rjac155

Cited by 1 publication

(1 citation statement)

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“…Chyloperitoneum, also known as chylous ascites, arises from the leakage of chyle, a milky fluid rich in triglycerides (TG), into the peritoneal cavity [1,2]. The diagnosis of chylous ascites remains relatively uncommon, and its precise incidence remains elusive.…”

Section: Introductionmentioning

confidence: 99%

Acute Chyloperitoneum with Small Bowel Volvulus: Case Series and Systematic Review of the Literature

Sinicropi,

Mazzeo,

Sofia

et al. 2024

JCM

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Introduction: Chyloperitoneum arises from lymph leakage into the abdominal cavity, leading to an accumulation of milky fluid rich in triglycerides. Diagnosis can be challenging, and mortality rates vary depending on the underlying cause, with intestinal volvulus being just one potential acute cause. Despite its rarity, our case series highlights chyloperitoneum associated with non-ischemic small bowel volvulus. The aims of our study include assessing the incidence of this association and evaluating diagnostic and therapeutic approaches. Material and Methods: We present two cases of acute abdominal peritonitis with suspected small bowel volvulus identified via contrast-enhanced computed tomography (CT). Emergency laparotomy revealed milky-free fluid and bowel volvulus. Additionally, we conducted a systematic review up to 31 October 2023, identifying 15 previously reported cases of small bowel volvulus and chyloperitoneum in adults (via the PRISMA scheme). Conclusions: Clarifying the etiopathogenetic mechanism of chyloperitoneum requires specific diagnostic tools. Magnetic resonance imaging (MRI) may be useful in non-emergency situations, while contrast-enhanced CT is employed in emergencies. Although small bowel volvulus infrequently causes chyloperitoneum, prompt treatment is necessary. The volvulus determines lymphatic flow obstruction at the base of the mesentery, with exudation and chyle accumulation in the abdominal cavity. Derotation of the volvulus alone may resolve chyloperitoneum without intestinal ischemia.

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Section: Introductionmentioning

confidence: 99%