Galvão Diogo, Bettencourt Rui, Soares Ana Cláudia, Bagnari Inês, Bonança Joana
Surgery, Hospital de Santo Espírito da Ilha Terceira, Angra do Heroísmo, PRT.
Cureus. 2024 Feb 1;16(2):e53379. doi: 10.7759/cureus.53379. eCollection 2024 Feb.
Chylous ascites is the exudation from lymphatic content to the peritoneum and is a rare situation that mostly occurs following medical causes like neoplasms or cirrhosis. However, trauma to the lymphatic system due to compression by masses or altered anatomy can be a trigger too. We describe a rare combination of a primary small bowel volvulus in a young healthy adult causing chylous ascites. Obstruction caused by a primary small bowell volvulus can re-arrange the lymphatics anatomy increasing their flow pressure which can lead to rupture and leak. This is an emergent scenario that needs to be addressed quickly because of bowel ischaemia. CT scan is the gold standard to expedite diagnosis and go to surgical treatment. Although it can be an impactful finding, treatment of the cause behind chylous ascites results in complete resolution without any bowel resection.
乳糜性腹水是淋巴液成分渗漏至腹膜腔，是一种罕见情况，大多继发于肿瘤或肝硬化等医学病因。然而，肿块压迫或解剖结构改变导致的淋巴系统创伤也可能是诱因。我们描述了一例年轻健康成年人原发性小肠扭转导致乳糜性腹水的罕见病例。原发性小肠扭转引起的梗阻可重新排列淋巴管解剖结构，增加其流动压力，进而导致破裂和渗漏。由于存在肠缺血，这是一种需要迅速处理的紧急情况。CT扫描是加快诊断并进行手术治疗的金标准。尽管这可能是一个重要发现，但针对乳糜性腹水病因的治疗可使病情完全缓解，无需进行任何肠切除术。
