Authors :
Dr. Mihir Dungrani; Dr. Pratik Dash; Dr. Jatin G Bhatt; Dr. J. G. Vagadia
Volume/Issue :
Volume 10 - 2025, Issue 1 - January
Google Scholar :
https://tinyurl.com/bk4zzck5
Scribd :
https://tinyurl.com/zcyjcht9
DOI :
https://doi.org/10.5281/zenodo.14613894
Abstract :
Introduction:
Chylous ascites is fluid buildup with elevated
triglycerides, caused by various conditions. Early
detection is crucial to prevent immunosuppression,
malnutrition, and other complications.
Presentation of case:
A 40-year-old woman presented with left groin
swelling. CT showed a 6x3x7 cm multiloculated collection,
mild ascites, and liver cysts. Exploration revealed turbid,
milky white fluid; analysis confirmed chylous ascites.
Post-op, the patient had a smooth recovery, with no
complications.
Clinical Discussion:
Chylous ascites, caused by cirrhosis, lymphatic
abnormalities, malignancy, or infections like tuberculosis,
presents diagnostic challenges. Treatment includes a low-
fat diet, MCTs, and TPN for unresponsive cases.
Conclusion:
Mycobacterial chylous ascites is rare but treatable
with antimycobacterial therapy, MCT diet, and
somatostatin analogs, while excluding HIV and
underlying infections in patients.
References :
- Lizaola B, Bonder A, Trivedi HD, et al.Review article: the diagnostic approach and current management of chylous ascites. AlimentPharmacol Ther 2017; 46: 816–824.
- Kumar A, Mandavdhare HS, Rana SS, et al.Chylous ascites due to idiopathic chronic pancreatitis managed with endoscopic stenting.Clin Res Hepatol Gastroenterol 2018; 42: e29–e31.
- Shaik IH, Gonzalez-Ibarra F, Khan R, et al.Chylous ascites in a patient with HIV/AIDS: a late complication of mycobacterium aviumcomplex-immune reconstitution inflammatorysyndrome. Case Rep Infect Dis 2014; 2014:268527.
- Rabie H, Lomp A, Goussard P, et al.Paradoxical tuberculosis associated immune reconstitution inflammatory syndrome presenting with chylous ascites and chylothorax in a HIV-1 infected child. J Trop Pediatr 2010;56: 355–358.
- Summachiwakij S, Tungsubutra W, Koomanachai P, et al. Chylous ascites and chylothorax due to constrictive pericarditis in a patient infected with HIV: a case report. J Med Case Rep 2012; 6: 163.
- Roca B, Arnedo A, Almenar L, et al. Chylothorax and chyloperitoneum caused by scrophulodermic tuberculosis. Europ J Int Med 1992; 3: 49–50.
- Press OW, Press NO, Kaufman SD. Evaluation and management of chylous ascites. Ann Intern Med. 1982;96(3):358-64.
- Sultan S, Pauwels A, Poupon R, Levy VG. [Chylous ascites in adults: Etiological, therapeutic and prognostic aspects. Apropos of 35 cases.] Ann Gastroenterol Hepatol (Paris). 1990;26(5):187-91 [in French]
- Steinemann DC, Dindo D, Clavien PA, Nocito A. Atraumatic chylous ascites: Systematic review on symptoms and causes. J Am Coll Surg. 2011;212(5):899-905.e1-4.
- Aalami OO, Allen DB, Organ CH. Chylous ascites: A collective review. Surgery. 2000;128(5):761-78.
Introduction:
Chylous ascites is fluid buildup with elevated
triglycerides, caused by various conditions. Early
detection is crucial to prevent immunosuppression,
malnutrition, and other complications.
Presentation of case:
A 40-year-old woman presented with left groin
swelling. CT showed a 6x3x7 cm multiloculated collection,
mild ascites, and liver cysts. Exploration revealed turbid,
milky white fluid; analysis confirmed chylous ascites.
Post-op, the patient had a smooth recovery, with no
complications.
Clinical Discussion:
Chylous ascites, caused by cirrhosis, lymphatic
abnormalities, malignancy, or infections like tuberculosis,
presents diagnostic challenges. Treatment includes a low-
fat diet, MCTs, and TPN for unresponsive cases.
Conclusion:
Mycobacterial chylous ascites is rare but treatable
with antimycobacterial therapy, MCT diet, and
somatostatin analogs, while excluding HIV and
underlying infections in patients.