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Isolated Lymphatic Injury Mimicking Bladder Rupture in a Young Male Following Blunt Trauma: A Case Report
Prashant Kumar Gupta1, Evan Botterman2, Sara Morgan2
1Department of Radiology, Rutgers Health-Newark Beth Israel Medical Center, Newark, New Jersey, USA.
Case Reports in Radiology
|April 29, 2026
Summary
Rare lymphatic injuries can cause chylous ascites after blunt abdominal trauma. This case highlights diagnosing and treating this unusual condition when common injuries are excluded but fluid collections persist.
Area of Science:
- Trauma Surgery
- Gastroenterology
- Lymphatic Imaging
Background:
- Blunt abdominal trauma evaluation can be challenging, especially with atypical presentations.
- Unusual injuries may mimic more common conditions, complicating diagnosis.
- Identifying the source of diffuse abdominal fluid is critical for appropriate management.
Purpose of the Study:
- To present a case of posttraumatic chylous ascites secondary to lymphatic injury.
- To emphasize the diagnostic challenges and management of rare causes of abdominal fluid collection.
- To highlight the importance of considering lymphatic injury in blunt abdominal trauma.
Main Methods:
- Case report of a 17-year-old male with blunt abdominal trauma.
- Initial imaging suggestive of bladder rupture, later ruled out by CT cystogram.
- Laparoscopy and exploratory laparotomy to identify the source of free fluid.
- Laboratory analysis of abdominal fluid to confirm chylous ascites (high triglycerides).
Main Results:
- Initial imaging falsely suggested bladder injury.
- Laparotomy revealed milky-white fluid consistent with chyle.
- Confirmed diagnosis of chylous ascites due to cisterna chyli lymphatic injury.
- Successful treatment with fibrin sealant, peritoneal drain, and specialized diet.
Conclusions:
- Posttraumatic chylous ascites from lymphatic injury is a rare but important consideration in blunt abdominal trauma.
- Diagnostic workup should include ruling out common injuries and considering rarer causes like lymphatic damage.
- Prompt diagnosis and appropriate management lead to favorable patient outcomes.
