Hsu Chih Hung, Yang Jin Ruei, Chiu Fang Ling, Hsieh Jan Sing
Department of Surgery, Mennonite Christian Hospital, Hualien, Taiwan.
J Minim Access Surg. 2024 Oct 1;20(4):443-445. doi: 10.4103/jmas.jmas_33_23. Epub 2023 May 10.
Chyloperitoneum (CP) is a rare complication after bariatric surgery. We present a 37-year-old female with CP caused by a bowel volvulus following a gastric clipping with proximal jejunal bypass for morbid obesity. An abdominal CT image of a mesenteric swirl sign and abnormal triglyceride level of ascites fluid can confirm the diagnosis. In this patient, laparoscopy demonstrated dilated lymphatic ducts caused by a bowel volvulus resulting in the exudation of chylous fluid into the peritoneal cavity. After the reduction of bowel volvulus, she made an uneventful recovery with complete resolution of the chylous ascites. The presence of CP could indicate a situation of small bowel obstruction in patients with a history of bariatric surgery.
乳糜性腹水是减重手术后一种罕见的并发症。我们报告一名37岁女性，因病态肥胖行胃切除术并近端空肠旁路术后发生肠扭转导致乳糜性腹水。肠系膜漩涡征的腹部CT图像和腹水甘油三酯水平异常可确诊。在该患者中，腹腔镜检查显示肠扭转导致淋巴管扩张，致使乳糜液渗入腹腔。肠扭转复位后，她恢复顺利，乳糜性腹水完全消退。对于有减重手术史的患者，乳糜性腹水的出现可能提示小肠梗阻情况。
