Haj Osman Osama
Faculty of Medicine, Aleppo University, Aleppo, Syria.
Ann Med Surg (Lond). 2024 Jun 21;86(8):4836-4839. doi: 10.1097/MS9.0000000000002255. eCollection 2024 Aug.
Chylous peritonitis is characterized by a sudden accumulation of chyle in the peritoneal cavity, leading to symptoms of an acute abdomen. This condition is quite rare, with less than 100 cases documented in the medical literature, and is often misdiagnosed.
The authors present a case of an acute abdomen in a young man who was initially suspected to have a perforated peptic ulcer. After laparotomy, the diagnosis of chylous peritonitis was confirmed. Despite extensive investigations, no underlying cause was identified. Treatment involved peritoneal lavage and placement of a pelvic drainage tube, with discharge after three days on a low-fat.
Chylous peritonitis is a relatively rare condition, occurring in ~1 in 20 000 individuals. Chyle leakage can be detected through various diagnostic modalities including ultrasound, computed tomography, laparoscopy, or exploratory laparotomy. In cases where a definitive etiology is not identified, treatment typically involves peritoneal lavage and drainage. Postoperative management focuses on a low-fat diet and somatostatin administration to prevent recurrence.
The present case highlights the importance of considering primary chylous peritonitis as a potential cause of acute abdomen in young patients. Future research should focus on identifying risk factors and establishing evidence-based guidelines for approaching this condition.
乳糜性腹膜炎的特征是乳糜在腹腔内突然积聚，导致急腹症症状。这种情况非常罕见，医学文献中记录的病例不到100例，且常被误诊。
作者介绍了一名年轻男性急腹症病例，该患者最初被怀疑患有消化性溃疡穿孔。剖腹手术后，确诊为乳糜性腹膜炎。尽管进行了广泛的检查，但未发现潜在病因。治疗包括腹腔灌洗和放置盆腔引流管，三天后低脂饮食出院。
乳糜性腹膜炎是一种相对罕见的疾病，发病率约为两万分之一。乳糜漏可通过多种诊断方法检测，包括超声、计算机断层扫描、腹腔镜检查或剖腹探查。在未确定明确病因的情况下，治疗通常包括腹腔灌洗和引流。术后管理重点是低脂饮食和给予生长抑素以预防复发。
本病例强调了将原发性乳糜性腹膜炎视为年轻患者急腹症潜在病因的重要性。未来的研究应侧重于确定危险因素，并建立针对这种情况的循证指南。
