Chylous ascites as a manifestation of hepatocellular carcinoma: A case report
DOI:
https://doi.org/10.59093/27112330.125Keywords:
chylous ascites, carcinoma, hepatocellular, transcatheter arterial chemoembolization, case report.Abstract
Chylous ascites is a rare and infrequent form of ascites resulting from the leakage of lipid-rich lymphatic fluid into the peritoneal cavity, most often secondary to trauma or obstruction. However, it can also be of infectious, cardiogenic, cirrhotic, or neoplastic origin, with the latter accounting for one-third of cases. The diagnosis is based on the characteristics of the ascitic fluid (AF), described as "milky", with triglyceride levels generally greater than 200 mg/dL. Management consists of treating the underlying disease causing it, along with dietary modifications and diuretics. In this article, we present a case of a patient with a history of alcohol-related liver disease who was admitted to the emergency department with a second episode of ascitic edematous decompensation and tense ascites, this time with evidence of turbid and chylous ascitic fluid, with triglyceride levels of 201 mg/dL. Subsequent evaluation led to a diagnosis of hepatocellular carcinoma. A low-fat diet supplemented with medium-chain triglycerides was prescribed, resulting in a decrease in AF triglyceride levels below 100 mg/dL and favorable clinical outcomes. Given the patient's ineligibility for transplantation, transarterial chemoembolization (TACE) was employed as a palliative treatment for the hepatocellular carcinoma.
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