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Case Reports
. 2018 Jun 19;18(1):43.
doi: 10.1186/s12893-018-0374-7.

Long standing biliary colic masking chylous ascites in laparoscopic roux-en-Y gastric bypass; a case report

Louai R Zaidan  1   2 , Elhaitham K Ahmed  1   2 , Bachar Halimeh  1 , Yasser Radwan  2 , Khalil Terro  3   4
Affiliations
Case Reports

Long standing biliary colic masking chylous ascites in laparoscopic roux-en-Y gastric bypass; a case report

Louai R Zaidan et al. BMC Surg. .

Abstract

Background: Chylous ascites is considered to be an intra-abdominal collection of creamy colored fluid with triglyceride content of > 110 mg/dL. Chylous ascites is an uncommon but serious complication of numerous surgical interventions. However, it is a rare complication of LRYGB. An internal hernia limb defect is thought to be the underlying etiology, where the hernia will cause lymphatic vessel engorgement and lymphatic extravasation.

Case presentation: We report a case of a 29 years old male with a 9 year history of laparoscopic Roux en y gastric bypass (LRGYB), presenting with recurrent abdominal pain for 2 months radiating to the right shoulder. Ultrasound examination revealed gallstones and the patient was subsequently admitted for laparoscopic cholecystectomy. Intraoperatively, whitish colored fluid, high in triglycerides content was aspirated. During exploration, an internal hernia limb defect was found and corrected.

Conclusion: Post LRGYB patients with symptoms of recurrent abdominal pain should be suspected for chylous ascites reflecting an internal hernia.

Keywords: Abdominal pain; Biliary colic; Chylous ascites; Internal hernia; LRYGB.

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Conflict of interest statement

Ethics approval and consent to participate

A written informed consent was obtained from the patient for the participation in this case report. This case report was approved and supervised in terms of ethics, consent and patient confidentiality by the Institutional Review Board (IRB) committee of the Specialized Medical Center Hospital (SMCH) in Riyadh, Saudi Arabia.

Consent for publication

A written informed consent was obtained from the patient for the publication of this case report.

Competing interests

The authors declare that they have no competing interests.

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