Acute pancreatitis with chylous ascites mimicking acute appendicitis: A rare case report

• Published in: International journal of surgery case reports Vol. 108; p. 108462
• Main Authors: Shah, Zaryab Ali, Fatima, Komal, Hamid, Hasnain, Ilyas, Muhammad, Nouman, Muhammad, Zeb, Muhammad
• Format: Report
• Language: English
• Published: 01.07.2023
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2023.108462

INTRODUCTION AND IMPORTANCEChylous ascites, characterized by the accumulation of lymphatic fluid in the peritoneal cavity, presents a significant diagnostic and management challenge, particularly in resource-limited settings. CASE PRESENTATIONWe report a case of a 63-year-old female with acute abdominal pain who was initially diagnosed with acute perforated appendicitis. During open surgery, Chylous ascites was found with normal appendix and bulky pancrease with surrounding fluid accumulation. Drain was placed in lesser sac area and appendectomy was performed with drain placed in right iliac fossa. Recovery was uneventful. CLINICAL DISCUSSIONChylous ascites can be challenging to diagnose, especially in resource-limited settings. Laboratory analysis and imaging studies play a critical role in establishing the diagnosis, while conservative measures and invasive interventions, if necessary, comprise the treatment strategy. CONCLUSIONOur case highlights the importance of considering chylous ascites as a potential differential diagnosis in acute abdomen cases. Accurate diagnosis and management can be particularly challenging in resource-limited settings, and increased awareness among clinicians and further research is necessary to improve outcomes for patients.