title: Acute chylous peritonitis mimicking ovarian torsion in a patient with advanced gastric carcinoma.
abstract: The extravasation of chyle into the peritoneal space usually does not accompany an abrupt onset of abdominal pain with symptoms and signs of peritonitis. The rarity of this condition fails to reach preoperative diagnosis prior to laparotomy. Here, we introduce a case of chylous ascites that presented with acute abdominal pain mimicking peritonitis caused by ovarian torsion in a 41-yr-old female patient with advanced gastric carcinoma. An emergency exploratory laparotomy was performed but revealed no evidence of ovarian torsion. Only chylous ascites was discovered in the operative field. She underwent a complete abdominal hysterectomy and salphingo-oophorectomy. Only saline irrigation and suction-up were performed for the chylous ascites. The postoperative course was uneventful. Her bowel movement was restored within 1 week. She was allowed only a fat-free diet, and no evidence of re-occurrence of ascites was noted on clinical observation. She now remains under consideration for additional chemotherapy.
authors.affiliation: Department of Surgery and Women's Cancer Clinic, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Chang Moo
authors.initials: CM
authors.lastname: Kang
authors.forename: Sunghoon
authors.initials: S
authors.lastname: Kim
authors.forename: Bub Woo
authors.initials: BW
authors.lastname: Kim
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Kim
authors.forename: Jin Sub
authors.initials: JS
authors.lastname: Choi
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Lee
authors.forename: Byong Ro
authors.initials: BR
authors.lastname: Kim
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology; D000328:Adult; D002915:Chylous Ascites / Q000175:diagnosis* / Q000209:etiology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010049:Ovarian Diseases / Q000175:diagnosis*; D013274:Stomach Neoplasms / Q000150:complications*; D014102:Torsion Abnormality / Q000175:diagnosis*