Abstract
A 65-year-old woman, who had undergone a partial gastrectomy at the age of 37, developed abdominal pain and came to our hospital. Enhanced CT examination detected the whirl sign and she was diagnosed as having a strangulated ileus. An emergency operation was performed, and three hours later her pain recurred. As we detected white ascites with a triglyceride level of 610mg/dL, we diagnosed chylous ascites. The ileum was not necrotic and was not resected. Though chylous ascites is produced by various diseases, chylous ascites induced by strangulated ileus is rare. A strangulated ileus may obstruct the flow of the lymph ducts whose pressure is low, and cause chylous ascites. Although fifteen cases of strangulated ileus with chylous ascites have been reported in Japan, no intestinal resection was needed in all cases. Strangulated ileus with chylous ascites should be operated on as early as possible to conserve the intestinal tract. We report herein on our case because strangulated ileus with chylous ascites is rare.
