Renée M Ward1, Charles R Rardin. 1. Department of Obstetrics and Gynecology, Women and Infants' Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island 02903, USA. rward@wihri.org
Abstract
BACKGROUND: Chylous ascites is a rare phenomenon caused by extravasation of chyle from the lymphatic system. In Western countries, the majority of adult cases are due to occlusion of the lymphatics secondary to a lymphoma or other malignancy. CASE: A middle-aged woman with reports of fecal urgency, incomplete bowel evacuation, and recurrent pelvic organ prolapse presented for surgical correction of a posterior vaginal defect. During the repair, a sac filled with milky white fluid was found ventral to the rectum. Further dissection revealed a large enterocele filled with chylous ascites. Postoperatively, diffuse lymphadenopathy was detected by computed tomography imaging, and a biopsy confirmed follicular lymphoma. CONCLUSION: Repair of symptomatic pelvic organ prolapse revealed underlying chylous ascites and lymphoma. Ascites may have exacerbated underlying support defects in the pelvic floor.
BACKGROUND:Chylous ascites is a rare phenomenon caused by extravasation of chyle from the lymphatic system. In Western countries, the majority of adult cases are due to occlusion of the lymphatics secondary to a lymphoma or other malignancy. CASE: A middle-aged woman with reports of fecal urgency, incomplete bowel evacuation, and recurrent pelvic organ prolapse presented for surgical correction of a posterior vaginal defect. During the repair, a sac filled with milky white fluid was found ventral to the rectum. Further dissection revealed a large enterocele filled with chylous ascites. Postoperatively, diffuse lymphadenopathy was detected by computed tomography imaging, and a biopsy confirmed follicular lymphoma. CONCLUSION: Repair of symptomatic pelvic organ prolapse revealed underlying chylous ascites and lymphoma. Ascites may have exacerbated underlying support defects in the pelvic floor.