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Case Reports
. 2017 Oct 25:4:e115.
doi: 10.14309/crj.2017.115. eCollection 2017.

Retroperitoneal Fibrosis as a Cause of Chylous Ascites

Adnan Ur Rahman  1 , Rajeswari Ramaraj  1 , Emyr Humphreys  2 , Elizabeth Slowinska  3
Affiliations
Case Reports

Retroperitoneal Fibrosis as a Cause of Chylous Ascites

Adnan Ur Rahman et al. ACG Case Rep J. .

Abstract

Retroperitoneal fibrosis is a rare condition characterized by chronic inflammation and marked fibrosis of the retroperitoneal tissue, often leading to entrapment of abdominal organs. We report a 69-year-old white man who presented with a 5-week history of gradual onset of progressive abdominal distension. He had no history or risk factors for an underlying liver condition. Ascites and a retroperitoneal mass encasing the major abdominal vessels were revealed on imaging. Biopsies of the mass confirmed the presence of retroperitoneal fibrosis, and the ascitic fluid was milky, consistent with chylous ascites. We discuss this rare presentation and the challenges of treatment for chylous ascites caused by RPF, including the role for supportive treatment.

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Figures

Figure 1
Figure 1
(A) Abdominal and (B) pelvic computed tomography confirming a retroperitoneal mass encasing the main abdominal vessels-mesenteric. Noted on the images are the renal and upper abdominal aorta (green arrow), the residual ascites with pigtail in situ (red arrow), and hydronephrosis with some ureteric obstruction (yellow arrow).
Figure 2
Figure 2
Hematoxylin and eosin stain showing fibrosis and inflammation (magnification 400×).
See this image and copyright information in PMC

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