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A Case Report of Chylous Ascites due to Poorly Differentiated Gastric Adenocarcinoma

Xinyu Liu1, Chunna Liu2*

Background: Chylous ascites refers to accumulation of milk-like peritoneal fluid rich in triglycerides in the abdominal cavity and is a rare presentation. The remaining causes of chylous ascites include lymphatic malformation, cirrhosis, tuberculosis, and malignancy.

Case Presentation: A 68-year-old man presented to our geriatric department with abdominal distention and edema of both lower limbs. The abdominal ultra-sound showed high volume ascites and the diagnostic paracentesis revealed milk-like peritoneal fluid rich in triglycerides. Upper digestive endoscopy was performed and revealed poorly differentiated gastric adenocarcinoma on biopsy. The patient was transferred to oncology department and died 2 weeks later.

Conclusion: Chylous ascites may be the earliest manifestation of poorly differentiated gastric adenocarcinoma, even if not accompanied by other symptoms of malignancy.