Abstract
An 88-year-old man who presented to our hospital because of upper abdominal pain and jaundice was found to have gas image within the gallbladder wall and the swollen gallbladder with presumably resulting thrombus formation and gas in the left branch of the portal vein on a contrast-enhanced abdominal CT scan. In order to remove the infected foci, an emergency cholecystectomy was performed. We started general administration of heparin as an anticoagulation therapy immediately after the operation. On and after the first postoperative day, oral ingestion was resumed and at the same time oral administration of warfarin was started. Thereafter portal thrombosis and gas persisted, whereas his clinical symptoms had been unchanged. On the third postoperative day, a yellowish white discharge was drained when triglyceride in the ascites increased. Chylous ascites was thus diagnosed. A low-fat diet resulted in an improvement of chylous ascites. The patient was discharged from the hospital.
