Retroperitoneal Fibrosis as a Cause of Chylous Ascites

Abstract

Retroperitoneal fibrosis is a rare condition characterized by chronic inflammation and marked fibrosis of the retroperitoneal tissue, often leading to entrapment of abdominal organs. We report a 69-year-old white man who presented with a 5-week history of gradual onset of progressive abdominal distension. He had no history or risk factors for an underlying liver condition. Ascites and a retroperitoneal mass encasing the major abdominal vessels were revealed on imaging. Biopsies of the mass confirmed the presence of retroperitoneal fibrosis, and the ascitic fluid was milky, consistent with chylous ascites. We discuss this rare presentation and the challenges of treatment for chylous ascites caused by RPF, including the role for supportive treatment.

Misdiagnosis and delayed diagnosis of atypical autoimmune pancreatitis: Experience from clinical cases

“…Ascites may result from compressed retroperitoneal lymphatic vessels, causing chylous ascites. 16 Therapeutic paracentesis can treat significant ascites. 17 The third patient remained free of recurrence for a prolonged period of 8 years after timely steroid therapy.…”

“…Our first patient demonstrated resolution of renal pelvis dilation and reduction in thickness of bladder trigone and ascites after receiving treatment. Ascites may result from compressed retroperitoneal lymphatic vessels, causing chylous ascites 16 . Therapeutic paracentesis can treat significant ascites 17 .…”

Chylous Ascites due to Mantle Cell Lymphoma

“…Although he responded favourably to diuretics, he died due to a nosocomial pneumonia. This case highlights the fact that although most cases of chylous ascites are related to trauma, some may be due to other causes such as lymphoproliferative diseases, pancreatitis [2] or retroperitoneal fibrosis [4] .…”