# Diagnostic Evaluation and Management of Idiopathic Chylous Ascites: A Report of a Surgical Case

**Authors:** Ann Wu, Roneil Parikh, Laurence Gluch

PMC · DOI: 10.7759/cureus.83562 · Cureus · 2025-05-06

## TL;DR

This paper presents a case of idiopathic chylous ascites and outlines a systematic approach for its diagnosis and treatment.

## Contribution

The paper introduces a systematic method to diagnose idiopathic chylous ascites by excluding alternative causes.

## Key findings

- A 39-year-old woman's idiopathic chylous ascites was diagnosed and treated successfully.
- Symptoms resolved completely over an eight-month follow-up period.
- A systematic diagnostic approach was proposed to identify ICA.

## Abstract

Chylous ascites (CA) is the pathological accumulation of lymphatic fluid in the peritoneal cavity. The ascitic fluid has a high concentration of triglycerides and chylomicrons, giving it a milky appearance. Owing to its infrequent diagnosis, there is limited literature describing the workup and treatment of idiopathic chylous ascites (ICA). This report describes the case of a 39-year-old woman who presented with undifferentiated abdominal pain, with the investigations leading to a diagnosis of ICA and interventions which led to complete resolution of symptoms over a follow-up period of eight months. We propose a systematic method to exclude alternative causes of chyle leak, thus aiding in the diagnosis of ICA.

## Linked entities

- **Diseases:** chylous ascites (MONDO:0008829)

## Full-text entities

- **Diseases:** CA (MESH:D002915), chyle leak (MESH:D019559), abdominal pain (MESH:D015746)
- **Chemicals:** triglycerides (MESH:D014280)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12138954/full.md

## References

13 references — full list in the complete paper: https://tomesphere.com/paper/PMC12138954/full.md

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Source: https://tomesphere.com/paper/PMC12138954