A Case of Strangulated Intestinal Obstruction with Chylous Ascites Treated by Laparoscopic Surgery

Abstract

A strangulated intestinal obstruction with chylous ascites is relatively rare, and most case reports were due to volvulus. A case of strangulated intestinal obstruction caused by a cord accompanied by chylous ascites, which was successfully relieved by laparoscopic surgery, is reported. A 47-year-old woman visited our hospital due to abdominal pain after meals. Contrast-enhanced abdominal computed tomography showed closed loop formation and delayed arterial enhancement without ascites. She was diagnosed with strangulated ileus, and emergency laparoscopic surgery was performed. A moderate amount of milky white chylous ascites was found in the peritoneal cavity, and the small intestine was strangled by a band caused by mesenteric adhesions. Since there was no suspicion of necrosis, the surgery was completed without intestinal resection. The patient's postoperative course was uneventful. When chylous ascites is found during surgery, intestinal resection is not required because the intestinal blood flow disorder is often mild. Chylous ascites could be an important indicator when deciding on intestinal preservation.