Spontaneous chylous peritonitis

Spontaneous chylous peritonitis is an exceedingly rare surgical presentation that involves spontaneous rupture of one or more lymphatic vessels intra-peritoneally. Chylous ascites are usually more involved in sinister scenarios such as malignancy, chronic inflammation, and trauma. It is seldom that spontaneous chylous ascites presents as acute peritonitis.

We reported a rare case of idiopathic chylous ascites presented as acute abdomen. This patient sought medical attention after having on-going abdomen pain and distension for 5 months, with no past medical or surgical history.

Chylous ascitis can, although rarely, be elicited spontaneously, and present in surgical acute abdomen. This rare case serves as a reminder for surgeons, when faced with similar findings, to consider spontaneous chylous ascitis as one of the differential diagnoses. Early diagnosis and prompt treatment is fundamental for improved outcomes for the patient.