Abstract
In strangulation ileus, it has been reported that chylous ascites can occur due to lymphatic obstruction resulting from axial torsion or other cause. Recently we have experienced a case of chylous ascites caused by an internal hernia, where the intestine could be kept intact.
A 30-year-old woman was brought into our hospital by ambulance because of abdominal pain. As right paraduodenal incarcerated hernia was suspected on an abdominal CT scan, emergency operation was performed. Reduction of the small bowel which had incarcerated into the parietal fossa resulted in extravasation of chylous ascites. Ischemic change of the intestine was observed, but peristalsis did not disappear. The bowel was thus determined to be conserved. Her postoperative course was uneventful and no recurrence has occurred.
In all cases of strangulation ileus associated with chylous ascites, their involved bowels were able to be conserved. However, researchers suggest a possibility of the change to develop irreversible bowel ischemia as time goes on. In the treatment of strangulated ileus associated with chylous ascites, we should consider a necessary and sufficient operative procedure while keeping the fact in mind that bowel conservation could be done in many cases.
