Idiopathic chylothorax-chylous ascites - A case report

Toshio Iida, Shinichi Kanehara, Satoko Shima, Noriko Hanamura, Kenji Tanikawa, Syunichi Nakagawa, Takashi Higashiguchi, Takazumi Imai, Tomohito Matushita, Kazuyoshi Nakamura

Research output: Contribution to journalArticle

Abstract

A 43-year-old woman was admitted because of right lower abdominal pain. There was no significant past medical or family history. Physical examination revealed right lower quadrant tenderness and rebound tenderness. A peripheral blood count showed a WBC count of 6800 cells/mm3. CRP was 2.1. A chest radiograph revealed the presence of bilateral pleural effusion. An abdominal CT scan sowed right prerenal fluid collection in the retro peritoneal space and perirectal ascites. US-guide aspiration of the ascetic fluid from Douglas' cul-de-sac yieled approximaterly 10 ml of milky fluid. The patient was treated conservatively and examined to determine the etiology of the chylous ascites. The pleural effusion consisted of approximately 240 ml of milky fluid. Lymphangioscintigrahy with 99mTc-HAS shwed decreased lymph flow around the external iliac lymph nodes, but no leakage of 99mTc-HAS into the thoracic cavity or abdominal cavity was detected. The lymphagiography findings were similar to those obtained by lymphagioscintigraphy. The WBC count decreased and the abdominal pain and rebound tenderness resolved in response to conservative therapy with no oral intake and parenteral nutrition. Five days after the onset of symptoms, the patient was placed on a fat-free diet. Based on the clinical and laboratory findings taken as a whole, a diagnosis of idiopathic chylothorax-chylous ascites was made. The clinical course was good, and the pleural effusion and ascites gradually resolved, allowing the patient to be discharged 18 days after the onset of symptoms. At the present, seven months after her discharge, she shows no evidence of recurrence of chylothorax-chylous ascites.

Original languageEnglish
Pages (from-to)21-24
Number of pages4
JournalMie Medical Journal
Volume50-51
Issue number1-3
Publication statusPublished - 01-12-2000
Externally publishedYes

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Chylous Ascites
Chylothorax
Pleural Effusion
Ascites
Abdominal Pain
Medical History Taking
Douglas' Pouch
Thoracic Cavity
Fat-Restricted Diet
Abdominal Cavity
Parenteral Nutrition
Lymph
Physical Examination
Thorax
Cell Count
Lymph Nodes
Recurrence

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Iida, T., Kanehara, S., Shima, S., Hanamura, N., Tanikawa, K., Nakagawa, S., ... Nakamura, K. (2000). Idiopathic chylothorax-chylous ascites - A case report. Mie Medical Journal, 50-51(1-3), 21-24.
Iida, Toshio ; Kanehara, Shinichi ; Shima, Satoko ; Hanamura, Noriko ; Tanikawa, Kenji ; Nakagawa, Syunichi ; Higashiguchi, Takashi ; Imai, Takazumi ; Matushita, Tomohito ; Nakamura, Kazuyoshi. / Idiopathic chylothorax-chylous ascites - A case report. In: Mie Medical Journal. 2000 ; Vol. 50-51, No. 1-3. pp. 21-24.
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Iida, T, Kanehara, S, Shima, S, Hanamura, N, Tanikawa, K, Nakagawa, S, Higashiguchi, T, Imai, T, Matushita, T & Nakamura, K 2000, 'Idiopathic chylothorax-chylous ascites - A case report', Mie Medical Journal, vol. 50-51, no. 1-3, pp. 21-24.

Idiopathic chylothorax-chylous ascites - A case report. / Iida, Toshio; Kanehara, Shinichi; Shima, Satoko; Hanamura, Noriko; Tanikawa, Kenji; Nakagawa, Syunichi; Higashiguchi, Takashi; Imai, Takazumi; Matushita, Tomohito; Nakamura, Kazuyoshi.

In: Mie Medical Journal, Vol. 50-51, No. 1-3, 01.12.2000, p. 21-24.

Research output: Contribution to journalArticle

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AU - Iida, Toshio

AU - Kanehara, Shinichi

AU - Shima, Satoko

AU - Hanamura, Noriko

AU - Tanikawa, Kenji

AU - Nakagawa, Syunichi

AU - Higashiguchi, Takashi

AU - Imai, Takazumi

AU - Matushita, Tomohito

AU - Nakamura, Kazuyoshi

PY - 2000/12/1

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N2 - A 43-year-old woman was admitted because of right lower abdominal pain. There was no significant past medical or family history. Physical examination revealed right lower quadrant tenderness and rebound tenderness. A peripheral blood count showed a WBC count of 6800 cells/mm3. CRP was 2.1. A chest radiograph revealed the presence of bilateral pleural effusion. An abdominal CT scan sowed right prerenal fluid collection in the retro peritoneal space and perirectal ascites. US-guide aspiration of the ascetic fluid from Douglas' cul-de-sac yieled approximaterly 10 ml of milky fluid. The patient was treated conservatively and examined to determine the etiology of the chylous ascites. The pleural effusion consisted of approximately 240 ml of milky fluid. Lymphangioscintigrahy with 99mTc-HAS shwed decreased lymph flow around the external iliac lymph nodes, but no leakage of 99mTc-HAS into the thoracic cavity or abdominal cavity was detected. The lymphagiography findings were similar to those obtained by lymphagioscintigraphy. The WBC count decreased and the abdominal pain and rebound tenderness resolved in response to conservative therapy with no oral intake and parenteral nutrition. Five days after the onset of symptoms, the patient was placed on a fat-free diet. Based on the clinical and laboratory findings taken as a whole, a diagnosis of idiopathic chylothorax-chylous ascites was made. The clinical course was good, and the pleural effusion and ascites gradually resolved, allowing the patient to be discharged 18 days after the onset of symptoms. At the present, seven months after her discharge, she shows no evidence of recurrence of chylothorax-chylous ascites.

AB - A 43-year-old woman was admitted because of right lower abdominal pain. There was no significant past medical or family history. Physical examination revealed right lower quadrant tenderness and rebound tenderness. A peripheral blood count showed a WBC count of 6800 cells/mm3. CRP was 2.1. A chest radiograph revealed the presence of bilateral pleural effusion. An abdominal CT scan sowed right prerenal fluid collection in the retro peritoneal space and perirectal ascites. US-guide aspiration of the ascetic fluid from Douglas' cul-de-sac yieled approximaterly 10 ml of milky fluid. The patient was treated conservatively and examined to determine the etiology of the chylous ascites. The pleural effusion consisted of approximately 240 ml of milky fluid. Lymphangioscintigrahy with 99mTc-HAS shwed decreased lymph flow around the external iliac lymph nodes, but no leakage of 99mTc-HAS into the thoracic cavity or abdominal cavity was detected. The lymphagiography findings were similar to those obtained by lymphagioscintigraphy. The WBC count decreased and the abdominal pain and rebound tenderness resolved in response to conservative therapy with no oral intake and parenteral nutrition. Five days after the onset of symptoms, the patient was placed on a fat-free diet. Based on the clinical and laboratory findings taken as a whole, a diagnosis of idiopathic chylothorax-chylous ascites was made. The clinical course was good, and the pleural effusion and ascites gradually resolved, allowing the patient to be discharged 18 days after the onset of symptoms. At the present, seven months after her discharge, she shows no evidence of recurrence of chylothorax-chylous ascites.

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Iida T, Kanehara S, Shima S, Hanamura N, Tanikawa K, Nakagawa S et al. Idiopathic chylothorax-chylous ascites - A case report. Mie Medical Journal. 2000 Dec 1;50-51(1-3):21-24.