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Chylous ascites due to sarcoidosis
1Department of Medicine, Louisiana State University School of Medicine, Shreveport.
The American Journal of Gastroenterology
|January 1, 1991
Summary
Systemic sarcoidosis can cause chylous ascites, a rare complication. This case highlights noncaseating granulomas in lymph nodes leading to this condition.
Area of Science:
- Internal Medicine
- Gastroenterology
- Pathology
Background:
- Systemic sarcoidosis is a multisystem inflammatory disease.
- Chylous ascites is the accumulation of lymphatic fluid in the peritoneal cavity, often idiopathic or secondary to malignancy or liver disease.
Observation:
- A 33-year-old female with known systemic sarcoidosis presented with chylous ascites.
- CT imaging revealed extensive mesenteric lymphadenopathy.
- Laparotomy confirmed enlarged, matted mesenteric and para-aortic lymph nodes replaced by noncaseating granulomas.
Findings:
- The patient's chylous ascites was refractory to corticosteroids and dietary changes.
- Repeated large-volume paracentesis was required for symptomatic relief.
Implications:
- This is the first documented case of chylous ascites caused by sarcoidosis.
- Sarcoidosis should be considered in the differential diagnosis of unexplained chylous ascites.
- Further research may explore the specific mechanisms linking sarcoidosis-related lymphadenopathy to chylous effusions.