Chylous ascites: Why exercise is bad for you.

Abstract

INTRODUCTION: The development of chylous ascites is usually associated with trauma, iatrogenic or otherwise. Blunt abdominal trauma producing hyperextension or hyperflexion may cause disruption to lymphatic vessels causing chylous ascites. PRESENTATION OF CASE: This report describes the case of a 38-year-old gentleman who presented to the emergency department with severe abdominal pain after completing a triathlon. As the patient was in severe pain, an abdominal CT was performed which demonstrated a possible mid gut volvulus. Subsequent laparotomy noted a significant volume of intra-abdominal chyle with no other abnormalities. DISCUSSION: This is the first report of chylous ascites occurring without associated abdominal pathology after a period of strenuous exercise. CONCLUSION: Chylous ascites can occur as a result of hyperreflexion and hyperextension injuries sustained during strenuous exercise.