Massive Chylous Ascites in a 9-Year-Old Girl with Malrotation—A Case Report

Abstract: Malrotation leading to massive chylous ascites is rare. A 9-year-old girl was investigated for slowly increasing abdominal distension under a year. She had no vomiting, weight loss, or pain, but was bothered in social situations. Medical investigations, including ultrasound and computed tomography scans, revealed massive ascites. Laparocentesis yielded milk-colored fluid, confirmed as lymph through laboratory analysis. A complete blood count, liver function and hematologic parameters, chyle cytology, bacterial cultures, and polymerase chain reaction for tuberculosis were all within normal limits. She was referred to a tertiary center for vascular anomalies. A dynamic contrast-enhanced magnetic resonance lymphangiography showed normal lymphatic anatomy without leakage or flow obstruction. A whole-body magnetic resonance imaging revealed a central mesenteric rotation. She was referred to a tertiary center for pediatric surgery, where a laparoscopic Ladd's procedure was performed using a new 5 mm pediatric sealing device, along with an appendectomy using a 5 mm stapler. To derotate the bowel, fenestrations were created in compartments containing a substantial amount of chyle and ascites, resulting in the drainage of 2.4 L of fluid. She was discharged the day after surgery and has been in good health for 1 year. We present a video illustrating the Ladd's procedure steps in this patient.

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: Massive Chylous Ascites in a 9-Year-Old Girl with Malrotation—A Case Report ; volume:12 ; number:01 ; year:2024 ; pages:e1-e3 ; European journal of pediatric surgery reports ; 12, Heft 01 (2024), e1-e3

Contributors, Places and Time

• Contributor: Winberg, Hans ; Gerwins, Pär ; Hagelsteen, Kristine

Further information

• DOI: 10.1055/a-2221-9682
• URN: urn:nbn:de:101:1-2024022910044664629846
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 14.06.2025, 9:35 AM CEST