MEDLINE Journals

    Chylous ascites secondary to hyperlipidemic pancreatitis with normal serum amylase and lipase.

    Authors
    Khan FY, Matar I 
    Institution

    Senior specialist, Department of Medicine, Hamad Medical Corporation, Doha, Qatar. fakhanqal@yahoo.co.uk

    Source
    World J Gastroenterol 2007 Jan 21; 13(3) :480-2.
    Abstract

    A 54-year old man with a family history of hyperlipidemia was admitted with a 12 h history of severe generalized abdominal pain associated with nausea, vomiting and abdominal distension. Examination of the abdomen revealed tenderness in the periumblical area with shifting dullness. Serum pancreatic amylase was 29 IU/L and lipase 44 IU/L, triglyceride 36.28 mmol/L. Ultrasound showed ascites. CT of the abdomen with contrast showed inflammatory changes surrounding the pancreas consistent with acute pancreatitis. Ultrasound (US) guided abdomen paracentesis yielded a milky fluid with high triglyceride content consistent with chylous ascites. The patient was kept fasting and intravenous fluid hydration was provided. Meperidine was administered for pain relief. On the following days the patient's condition improved and he was gradually restarted on a low-fat diet, and fat lowering agent (gemfibrozil) was begun, 600 mg twice a day. On d 14, abdomen US was repeated and showed fluid free peritoneal cavity. The patient was discharged after 18 d of hospitalization with 600 mg gemfibrozil twice a day. At the time of discharge, the fasting triglyceride was 4.2 mmol/L. After four weeks the patient was seen in the clinic, he was well.

    Mesh
    Amylases
    Chylous Ascites
    Humans
    Hyperlipidemias
    Lipase
    Male
    Middle Aged
    Pancreatitis
    Language

    eng

    Pub Type(s)
    Case Reports Journal Article
    PubMed ID

    17230625

    Content Manager
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