J Korean Surg Soc.  2011 Dec;81(Suppl 1):S64-S68. 10.4174/jkss.2011.81.Suppl1.S64.

Chylous ascites caused by acute pancreatitis with portal vein thrombosis

• Park DE
• Chae KM

• KMID: 1445789
• DOI: http://doi.org/10.4174/jkss.2011.81.Suppl1.S64

Abstract

Chylous ascites is defined as the accumulation of chyle in the peritoneum due to obstruction or rupture of the peritoneal or retroperitoneal lymphatic glands. Chylous ascites that arises from acute pancreatitis with portal vein thrombosis is very rare. We report here on a case of chylous ascite that was caused by acute pancreatitis with portal vein thrombosis, in which the patient showed an impressive response to conservative therapy with total parenteral nutrition and octerotide. We also review the relevant literature about chylous ascites with particular reference to the management of this rare disease.

Keyword

Chyle; Chylous ascites; Acute pancreatitis; Portal vein thrombosis; Pancreatic neoplasms

MeSH Terms

Chyle
Chylous Ascites
Humans
Pancreatic Neoplasms
Pancreatitis
Parenteral Nutrition, Total
Peritoneum
Portal Vein
Rare Diseases
Rupture
Thrombosis

Figure

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  Fig. 1 Computed tomography scan showing portal vein thrombosis with cavernous change of portal vein before chylous ascites occurred.

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  Fig. 2 Computed tomography scan showing large amount of ascites with portal vein thrombosis and head of pancreas showed edematous enlargement with mild pancreatic duct dilatation.

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  Fig. 3 Paracentesis drained some of milky whitish color fluid with high triglyceride level of 577 mg/L and albumin level of 1.3 g/L, which is consistent with chylous ascites.

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  Fig. 4 Positron emission tomography-computed tomography showed hot uptake of radioactive agent in only entire pancreas without abnormal uptake of peritoneal organs and lymph nodes.

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