A Rare Cause of Abdominal Compartment Syndrome: Chylous Ascites in non-Hodgkin's Lymphoma

Marjan Alidoost
2019 Advancements in Case Studies  
Abdominal compartment syndrome (ACS) carries a significant morbidity and mortality. It typically affects surgical patients, such as trauma patients, burn patients, and patients with recent abdominal surgery [1]. However, it carries a significantly worse mortality in nonsurgical patients and requires critical attention to these patients. ACS is diagnosed as intraabdominal pressure (IAP) over 20mmHg with accompanying new onset organ failure [1]. Even with treatment, mortality is high in patients
more » ... s high in patients with ACS [1]. Signs and symptoms include abdominal pain, shortness of breath, tachypnea, acute renal failure and bowel ischemia [1] . ACS can also be a life-threatening manifestation of cirrhosis, malignancy, acute pancreatitis or retroperitoneal bleed [2]. In our case, the patient had increasing abdominal girth over three weeks and presented to the Emergency Department with sudden onset of abdominal pain and dyspnea. He underwent emergent paracentesis with 13 liters of chylous fluid drained and was eventually diagnosed with stage IV follicular lymphoma. This case reports a rare presentation of ACS due to chylous ascites in the setting of follicular lymphoma. We highlight the importance of pursuing a through workup for causes of chylous ascites as well as understanding the underlying mechanisms and management of ACS. Case Report A 60-year-old male from New Jersey, United States with a medical history of coronary artery disease status post coronary artery bypass graft x4, hypertension, hyperlipidemia presented to the Emergency Department (ED) with shortness of breath. Three weeks
doi:10.31031/aics.2019.02.000535 fatcat:7slz2yuxdvdwfchv5dr6xrc4w4