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Case report of chylous ascites with strangulated ileus and review of the literature

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Abstract

We describe a case of chylous ascites with strangulated ileus, and review all 22 cases (including our case) of chylous ascites with strangulated ileus reported in the English and Japanese literature. The patient we describe was a 51-year-old woman with medical history of radiotherapy for cervical cancer of the uterus 15 months prior to being admitted to our hospital with abdominal pain after consuming a meal. A computed tomography (CT) scan revealed ascites, expansion of the small intestine, and whirl sign. Laparotomy revealed chylous ascites with an incarcerated internal hernia of the small intestine, which was released without intestinal resection. In our case the postoperative phase was uneventful, and as in the other 21 literature cases reviewed, treatment by either detorsion, release of the incarcerated internal hernia, or incision of the adhesion band without intestinal resection resulted in rapid improvement in the color of the intestine. It is considered that minimally invasive laparoscopic laparotomy should be selected as the treatment of first choice, because the degree of strangulation is slight in cases where chylous ascites is associated with strangulated ileus.

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Abbreviations

CT:

Computed tomography

NEUT:

Nitrophilic leukocyte

CRP:

C-reactive protein

LL:

Laparoscopic laparotomy

POD:

Postoperative day

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Disclosures

Conflict of interest: Yukari Harino and other co-authors have no conflict of interest.

Human/Animal Rights: This study does not contain any data about human or animal subjects.

Informed Consent: This study does not involve human subjects.

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Authors and Affiliations

  1. Department of Surgery, Taoka Hospital, Tokushima, Japan

    Yukari Harino, Hitomi Kamo, Takeshi Yamaguchi, Yuko Sumise, Natsu Okitsu, Kazuo Yoshioka & Seiki Tashiro

  2. Department of Emergency, Taoka Hospital, Tokushima, Japan

    Yuki Yoshioka

  3. Department of Digestive and Transplantation Surgery, The University of Tokushima Graduate School, Tokushima, Japan

    Kazuo Yoshioka

  4. Professor Emeritus, The University of Tokushima, Tokushima, Japan

    Seiki Tashiro

  5. Medical Adviser of Taoka Hospital, 4-2-2 Bandai-cho, Tokushima, 770-0941, Japan

    Seiki Tashiro

Authors
  1. Yukari Harino
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  2. Hitomi Kamo
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  3. Yuki Yoshioka
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  4. Takeshi Yamaguchi
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  5. Yuko Sumise
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  6. Natsu Okitsu
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  7. Kazuo Yoshioka
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  8. Seiki Tashiro
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Correspondence to Yukari Harino.

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Harino, Y., Kamo, H., Yoshioka, Y. et al. Case report of chylous ascites with strangulated ileus and review of the literature. Clin J Gastroenterol 8, 186–192 (2015). https://doi.org/10.1007/s12328-015-0573-z

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  • DOI: https://doi.org/10.1007/s12328-015-0573-z

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