Incidental chylous fluid during hernia repair may be a harbinger of malrotation.

A previously asymptomatic 12-week-old male infant was found to have chylous ascites within his peritoneal hernia sacs during elective open bilateral inguinal hernia repair. Both repairs were completed, and an immediate postoperative upper gastrointestinal contrast study confirmed the presence of malrotation with associated volvulus. The patient underwent a Ladd's procedure and appendectomy. The postoperative course was uneventful. The finding of chylous ascites during hernia repair mandates investigation for possible malrotation.