Acute chylous peritonitis mimicking ovarian torsion in a patient with advanced gastric carcinoma.
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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. (+info)
Peritoneovenous shunting for intractable chylous ascites complicated with lymphangioleiomyomatosis.
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A 38-year-old woman was admitted due to lymphangioleiomyomatosis (LAM)-associated massive chylous ascites and progressive cachexia. She was incidentally diagnosed to have ascites during her regular physical check-up two years previously and LAM was revealed as its underlying cause. Periodic paracentesis was required to ameliorate ascites-associated symptoms, but resulted in lymphocytopenia, malnutrition, and deterioration of general status. Ascites was refractory to diuretics and fat-restricted diet. Peritoneovenous shunt (Denver shunt) was placed and thereafter ascites has been managed successfully without any complications for one year after the placement. Peritoneovenous shunt should be considered in LAM patients whose chylous ascites can not be managed with conservative treatments. (+info)
Chylous ascites: an unusual complication of peritoneal dialysis. A case report and literature review.
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Chylous ascites is a rare complication in patients undergoing peritoneal dialysis. It may occur due to traumatic peritoneal dialysis catheter insertion or other causes. It is important to be aware of this condition as it may be confused with peritonitis, and antibiotics may be inappropriately administered. We report a case of chylous ascites occurring after catheter insertion and discuss management of this condition. (+info)
Lercanidipine-induced chyloperitoneum in patients on peritoneal dialysis.
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OBJECTIVE: Lercanidipine is a lipophilic calcium channel blocker and a widely used antihypertensive agent. However, it can cause chyloperitoneum in patients receiving peritoneal dialysis (PD). The incidence, pathophysiology, and clinical impact of these adverse events are not known. DESIGN: Retrospective study. METHOD: Patients were screened for use of antihypertensive agents. Those that had taken lercanidipine were identified and dialysate cholesterol (Chol) and triglyceride (TG) levels were checked. Serum levels were taken from the routine biochemistry record closest to the time of the dialysate levels. Dialysate Chol and TG from patients on other antihypertensives and with matched serum lipid profiles were compared. PATIENTS: 14 of 222 patients had taken lercanidipine during February 2005 to January 2006, accounting for 12% of all patients on calcium channel blockers in our PD center. RESULTS: Of 14 patients prescribed lercanidipine, 8 (57%) developed chyloperitoneum. None had peritonitis and the dialysate was clear under microscopic examination. Mean dialysate TG was 128.4 +/- 133.0 mg/dL and mean dialysate Chol was 18.2 +/- 24.9 mg/dL in patients that developed chyloperitoneum. These patients were also noted to have higher blood TG and Chol than patients that did not develop chyloperitoneum. In contrast, patients on other antihypertensive agents with matched blood TG and Chol levels had low dialysate TG levels and zero dialysate Chol. CONCLUSION: Lercanidipine frequently causes chyloperitoneum in Taiwanese PD patients. The risk of developing this adverse event seems to be related to the blood lipid profile. The mechanism of this phenomenon is worthy of further investigation. (+info)
Acute chylous ascites mimicking acute appendicitis in a patient with pancreatitis.
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We report a case of acute chylous peritonitis mimicking acute appendicitis in a man with acute on chronic pancreatitis. Pancreatitis, both acute and chronic, causing the development of acute chylous ascites and peritonitis has rarely been reported in the English literature. This is the fourth published case of acute chylous ascites mimicking acute appendicitis in the literature. (+info)
Chylous ascites requiring surgical intervention after donor nephrectomy: case series and single center experience.
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A pleuro-peritoneal communication through the diaphragm affected with lymphangioleiomyomatosis.
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A 30-year-old Japanese woman with lymphangioleiomyomatosis (LAM) developed a left chylothorax and chylous ascites. A pleuro-peritoneal communication was confirmed by a scintigram with (99)mTc-labeled macroaggregated-albumin injected into the peritoneal cavity. Video-assisted thoracic surgery revealed a protruding papillary lesion on the left diaphragm. Chyle was oozing into the pleural cavity through this lesion. Histopathological analyses demonstrated that the protrusion was a diaphragmatic LAM lesion and that LAM-associated lymphangiogenesis enabled communication between the pleural and peritoneal cavities through lymphatic vessels. This case demonstrated a new mechanism for chylous pleural effusion in LAM and illustrates the significance of LAM-associated lymphangiogenesis. (+info)
Chylous ascites and chylothorax: an unusual manifestation of cardiac amyloidosis.
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Restrictive cardiomyopathy is an extremely rare cause of massive chylous ascites and chylothorax. We report a 56-year-old man patient who presented with chylous ascites and bilateral chylothorax; 12-lead electrocardiography and echocardiography revealed restrictive cardiomyopathy. Endomyocardial biopsy disclosed amyloidosis. (+info)