A Rare Case of Chylous Ascites: A Case Report


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 :

  1. 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.
  2. 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.
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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.

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