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Milky Mesentery: Acute Abdomen with Chylous Ascites

Aakanksha Goel1, Manish Kumar Gaur2, Pankaj Kumar Garg2

  • 1Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, Delhi, India. Correspondence to: Dr Aakanksha Goel, House No 1 Sukh Vihar, Delhi 110 051, India. goelaakanksha@hotmail.com.

Indian Pediatrics
|November 15, 2018
PubMed

Insights

Acute peritonitis can signal primary intestinal lymphangiectasia, a rare condition causing chylous ascites. Early diagnosis is crucial for managing this malabsorptive disorder.

Area of Science:

  • Gastroenterology
  • Pediatric Surgery
  • Medical Diagnostics

Background:

  • Intestinal lymphangiectasia presents with edema, ascites, effusions, diarrhea, malabsorption, and obstruction.
  • Primary intestinal lymphangiectasia is a rare condition affecting lymphatic drainage.

Observation:

  • An 8-year-old boy presented with peritonitis symptoms, suggesting perforation.
  • Diagnostic laparotomy was performed due to clinical suspicion.

Findings:

  • Laparotomy confirmed chylous ascites and primary intestinal lymphangiectasia.
  • The patient's presentation mimicked surgical emergencies like appendicitis or bowel perforation.

Implications:

  • Acute peritonitis can be an initial clinical manifestation of primary intestinal lymphangiectasia.
  • This case highlights the importance of considering rare diagnoses in pediatric surgical emergencies.
  • Recognizing this association can lead to timely diagnosis and management of chylous ascites.
Abstract

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