Abstract
A 66-year-old woman admitted to our hospital because of a 2-day history of back pain. She had neither fever nor stomachache. The laboratory data showed high inflammatory reaction, including the white blood cell count of 22,290/μl and the CRP of 35 mg/dl. Abdominal simple CT scans revealed a low density area in the retroperitoneal space which was 8 cm in diameter. The space was located in the left side of the abdominal aorta and from the 3rd to 5th lumbar vertebrae. Abdominal ultrasongraphy showed a low echoic lesion of homogeneous density. We diagnosed it as retroperitoneal abscess formation, and an emergent operation was performed on the same day. Midline laparotomy disclosed fluid collection in the retroperitoneal space, and 350 ml of milky fluid was drained. We washed the space using saline and placed a closed suction drain. The fluid was odorless and showed a high TG finding (1,129 mg/dl), so we diagnosed it as chylorrhea. She took low fat diet from the 2nd postoperative day and the drain was removed on the 9th postoperative day. She was discharged from our hospital on the 12th postoperative day. Because she had no previous histories of recieving operations or injury, idiopathic retroperitoneal chylorrhea was diagnosed. We report the case with a review of previous reports of similar cases.
