Chylous ascites as a sequelae of primary small bowel volvulus in a virgin abdomen

Chylous ascites (CA) results in a thick white ascitic fluid, akin to milk. It is most commonly caused by malignancy and cirrhosis in adults. Here we present only the second reported case of primary small bowel volvulus resulting in CA in the virgin abdomen. The patient presented with acute onset, severe abdominal pain. She underwent an urgent laparotomy where a large volume of CA was drained. The bowel and its mesentery were congested with chyle and stained white. Following detorsion the bowel returned to normal, and the patient recovered well. Here we review the radiological findings and aetiology of CA, due to small bowel volvulus. This case highlights the importance of timely surgical intervention in patients with volvulus to prevent irreversible bowel ischaemia and if untreated, perforation.