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Case Reports
. 2026 Jan 14;13(1):e01959.
doi: 10.14309/crj.0000000000001959. eCollection 2026 Jan.

Chylous Ascites From Cirrhosis-Related Portal Hypertension Treated With Medium-Chain Triglycerides, Octreotide, and Paracentesis

John Derek C Clutario  1 , Christine P Velasquez  1 , Sharlene Nicole L Chan  1 , Madalinee Eternity D Labio  1 , Angelo Jonathan D Cruz  1
Affiliations
Case Reports

Chylous Ascites From Cirrhosis-Related Portal Hypertension Treated With Medium-Chain Triglycerides, Octreotide, and Paracentesis

John Derek C Clutario et al. ACG Case Rep J. .

Abstract

Chylous ascites is a rare complication of cirrhosis-related portal hypertension, accounting for less than 1% of ascites cases. We report a 76-year-old diabetic woman with prior breast cancer and cirrhosis secondary to metabolic dysfunction-associated fatty liver disease presenting with abdominal distension, bloating, and dyspnea. Paracentesis revealed pink milky chylous fluid with triglycerides of 269 mg/dL. Malignancy was excluded by cytology and positron emission tomography-computed tomography. Treatment with a medium-chain triglyceride diet, fat-soluble vitamins, diuretics with albumin, octreotide (200 μg/d), and paracentesis led to clinical improvement. This case underscores the rarity of chylous ascites and the efficacy of multimodal conservative management.

Keywords: chylous ascites; cirrhosis; medium-chain fatty acids; paracentesis; portal hypertension.

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References

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