title: Intestinal torsion causing chylous ascites: a rare occurrence.
abstract: Intestinal torsion and chylous ascites are very rarely associated. We present the case of a 19-year-old man who presented with acute abdomen. Computed tomography of his abdomen showed features suggestive of intestinal torsion. Chylous ascites was incidentally discovered on exploratory laparotomy. The chylous fluid was drained, the small bowel detorted and the coloduodenal adhesion band taken down. The patient's retroperitoneum was explored to exclude occult masses and malformations of the lymphatics. Post surgery, the patient recovered uneventfully. In this case, we postulate that intestinal malrotation had caused the obstruction of the lymphatic flow from the mesenteric lymphatic channels, leading to the exudation of chyle, which then resulted in the accumulation of chylous fluid in the peritoneal cavity. It is important to exclude the more common causes of atraumatic chylous ascites, such as enlarged retroperitoneal lymph nodes or lymphatic malformations.
authors.affiliation: Department of General Surgery, Singapore General Hospital, Outram Road, Singapore. yexin_koh@hotmail.com
authors.forename: Ye Xin
authors.initials: YX
authors.lastname: Koh
authors.forename: Jack Kian
authors.initials: JK
authors.lastname: Chng
authors.forename: Hwei Ching
authors.initials: HC
authors.lastname: Tan
authors.forename: Alexander Yaw Fui
authors.initials: AY
authors.lastname: Chung
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis / Q000601:surgery; D002915:Chylous Ascites / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D045822:Intestinal Volvulus / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D007422:Intestines / Q000002:abnormalities; D007813:Laparotomy; D008196:Lymph / Q000378:metabolism; D008297:Male; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult