Retroperitoneal Liposarcoma with `Milky Abdomen` in Elective Laparoscopic Cholecystectomy (a Case Report)

Abstract

Introduction: Chylous ascites (milky abdomen) is the extravasation of milky chyle into the peritoneal cavity. Multiple causes have been described (аbdominal surgery, blunt abdominal trauma, malignant neoplasms etc.). We present a case of incidental discovery of chylous ascites during elective laparoscopy for cholecystectomy.Materials and Methods: A fifty-eight-year-old female patient was admitted in our hospital for elective cholecystectomy. She was prepared preoperatively and operated on laparoscopically. During the intraoperative exploration, a milky abdomen was found. The operations was aborted. Postoperative CT scan showed retroperitoneal tumor mass in the upper abdomen. The patient was reoperated with exploratory laparotomy, without a milky abdomen this time! A block-tumor in the radix of the mesenterium was found, without a possibility for its extirpation. A biopsy was taken. It showed a presence of liposarcoma. The patient was discharged on the 8th postoperative day and was sent to oncology.Discussion: Raised intraabdominal pressure during laparoscopy provoked lymphorrhea in this case. It was not present during the laparotomy (normal intraabdominal pressure).