Abstract
A 63-year-old man visited our hospital suffering from sudden abdominal pain after an evening meal. Abdominal computer tomography revealed slight ascites, intestinal dilatation and whirl sign with the superior mesenteric artery as the axis. The patient was diagnosed with strangulated ileus and underwent an emergency laparotomy. The laparotomy revealed a moderate amount (ca. 550 ml) of chylous ascites and the milky surfaces of the small intestine and the mesentery. Furthermore, we found a 270-degree torsion of the mesentery with the superior mesenteric artery as the axis. After the torsion was freed, the color of the small intestine and the mesentery improved. Since intestinal blood flow improved, intestinal resection was not performed. The patient was discharged on day 7 of hospitalization. The potential for strangulated ileus presenting with chylous ascites was suggested as a result of the lymph flow being interrupted, and even in cases of strangulation that would not completely interrupt the blood flow.
