title: Chylous ascites post open cholecystectomy after severe pancreatitis.
abstract: BACKGROUND
  Chylous ascites a rare complication post cholecystectomy. There are to our knowledge only 3 reported cases in the literature. We describe a case of chylous ascites post open cholecystectomy in a patient with recent severe pancreatitis. We propose a potential relationship between acute biliary pancreatitis and the development of chylous ascites.
  
  
  METHODS
  We present a 37 year old man with a history of severe biliary pancreatitis 10 months prior. He was electively admitted for laparoscopic cholecystectomy. His surgery was converted to open cholecystectomy due to adhesions. A closed, non suction drain was placed intraoperatively draining serosanguinous fluid. Two days post operatively the draining fluid changed to a milky colour fluid with high triglyceride level. Chylous ascites was confirmed clinically with a 24 hour fast. He was treated with total parenteral nutrition. His chylous ascites resolved with conservative management and his drain was removed.
  
  
  CONCLUSIONS
  We describe the diagnosis and management of chylous ascites post cholecystectomy. We propose the hypothesis to the aetiology of this rare condition, based on ours and one previous case, that a history of recent severe acute pancreatitis poses a risk factor in the development of chylous ascites.
authors.affiliation: Department of Surgery, Adelaide and Meath Incorporating the National Children's Hospital, Tallaght, Dublin, Ireland. cheungx@tcd.ie
authors.forename: Cherry X
authors.initials: CX
authors.lastname: Cheung
authors.forename: Michael E
authors.initials: ME
authors.lastname: Kelly
authors.forename: Omer
authors.initials: O
authors.lastname: El Tayeb
authors.forename: William C
authors.initials: WC
authors.lastname: Torregianni
authors.forename: Paul F
authors.initials: PF
authors.lastname: Ridgway
mesh_terms: D000328:Adult; D002763:Cholecystectomy / Q000009:adverse effects*; D002915:Chylous Ascites / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D004322:Drainage; D006801:Humans; D008297:Male; D010195:Pancreatitis / Q000601:surgery*; D010289:Parenteral Nutrition, Total; D012307:Risk Factors; D016896:Treatment Outcome