Symptomatic enterocele. An unusual presentation of chylous ascites and lymphoma.
BACKGROUND
Chylous ascites is a rare phenomenon caused by extravasation of chyle from the lymphatic system. In Western countries, the majority of adult cases are due to occlusion of the lymphatics secondary to a lymphoma or other malignancy.


METHODS
A middle-aged woman with reports of fecal urgency, incomplete bowel evacuation, and recurrent pelvic organ prolapse presented for surgical correction of a posterior vaginal defect. During the repair, a sac filled with milky white fluid was found ventral to the rectum. Further dissection revealed a large enterocele filled with chylous ascites. Postoperatively, diffuse lymphadenopathy was detected by computed tomography imaging, and a biopsy confirmed follicular lymphoma.


CONCLUSIONS
Repair of symptomatic pelvic organ prolapse revealed underlying chylous ascites and lymphoma. Ascites may have exacerbated underlying support defects in the pelvic floor.
Ward
Renée M
RM
Department of Obstetrics and Gynecology, Women and Infants' Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island 02903, USA. rward@wihri.org
Rardin
Charles R
CR
D002915:Chylous Ascites / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006547:Hernia / Q000175:diagnosis / Q000209:etiology*; D059685:Herniorrhaphy; D006801:Humans; D008223:Lymphoma / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D008875:Middle Aged; D014596:Uterine Prolapse / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery