{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T20:08:03Z","timestamp":1781294883747,"version":"3.54.1"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T00:00:00Z","timestamp":1606780800000},"content-version":"vor","delay-in-days":335,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Intestinal malrotation is a rare etiology of chylous ascites in adolescents. Chylous ascites is caused by lymphatic system disarrangement, which can result in an anomalous build-up of a lymphatic fluid rich in lipid, namely chyle in the peritoneal cavity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case<\/jats:title>\n                    <jats:p>We present a case of a 16-year-old Saudi Arabian male who came to the emergency department with right upper quadrant pain associated with difficulty in passing stool for one day and a history of congenital diaphragmatic hernia (CDH) repair at the age of 4 months. Free fluid in the abdomen was noticed in the bedside ultrasound. Abdominopelvic computed tomography revealed dilated small bowel loops and a whirl sign of the mesentery, which indicated intestinal torsion. The patient was treated using Ladd\u2019s procedure, and a large volume of chylous fluid was removed from the abdomen. Postoperatively, the abdominal drain revealed no chyle, and the patient was followed-up as an outpatient at which point, he reported no abdominal pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Intestinal malrotation is more commonly reported in children and associated with congenital chylous ascites. Chylous ascites by itself is a rare occurrence, and very few cases attribute it to intestinal malrotation in adults. Surgical management with Ladd\u2019s procedure is a well-documented surgery in pediatric patients, and yet it was successfully performed in our adolescent patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Surgical management of chylous ascites secondary to intestinal malrotation in an adolescent, which is considered novel in this age group, including peritoneal lavage of chyle, resulted in favorable outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.12.004","type":"journal-article","created":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T13:23:22Z","timestamp":1607001802000},"page":"894-898","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Intestinal malrotation causing chylous ascites in an adolescent"],"prefix":"10.1097","volume":"77","author":[{"given":"Saad Mohammed","family":"Alshahrani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mughis Ahmed","family":"Saeed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah Saleh","family":"Alghamdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Saad","family":"Alameri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-202-20260114","doi-asserted-by":"crossref","first-page":"105","DOI":"10.14218\/JCTH.2017.00035","article-title":"Chylous ascites: a review of pathogenesis, diagnosis and treatment","volume":"6","author":"Bhardwaj","year":"2018","journal-title":"J. Clin. Transl. Hepatol"},{"key":"R2-202-20260114","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2015\/649303","article-title":"Chylous ascites: a rare adverse effect of methimazole treatment for Grave\u2019s Disease\u2014a case report and review of the literature","volume":"2015","author":"Khoury","year":"2015","journal-title":"Case Rep. Endocrinol"},{"key":"R3-202-20260114","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/j.jpedsurg.2017.05.031","article-title":"Congenital chylous ascites in infants: another presentation of intestinal malrotation","volume":"53","author":"Long","year":"2018","journal-title":"J. Pediatr. Surg"},{"key":"R4-202-20260114","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.ijsu.2018.10.028","article-title":"The SCARE 2020 statement: updating consensus Surgical CAse REport (SCARE) guidelines","volume":"60","author":"Agha","year":"2018","journal-title":"Int. J. Surg"},{"key":"R5-202-20260114","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1007\/BF02010316","article-title":"The diagnosis of malrotation and volvulus in the older child and adult: a trap for radiologists","volume":"25","author":"Berdon","year":"1995","journal-title":"Pediatr. Radiol"},{"key":"R6-202-20260114","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/240473","article-title":"Chylous ascites: evaluation and management","volume":"2014","author":"Al-Busafi","year":"2014","journal-title":"ISRN Hepatol"},{"key":"R7-202-20260114","doi-asserted-by":"crossref","first-page":"466","DOI":"10.3390\/jcm8040466","article-title":"Calcium channel blocker-related chylous ascites: a systematic review and meta-analysis","volume":"8","author":"Tsai","year":"2019","journal-title":"J. Clin. Med"},{"key":"R8-202-20260114","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1111\/apt.14284","article-title":"Review article: the diagnostic approach and current management of chylous ascites","volume":"46","author":"Lizaola","year":"2017","journal-title":"Aliment. Pharmacol. Ther"},{"key":"R9-202-20260114","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1055\/s-0039-1692165","article-title":"Malrotation in congenital diaphragmatic hernia: is it really a problem?","volume":"30","author":"Heiwegen","year":"2020","journal-title":"Eur. J. Pediatr. Surg"},{"key":"R10-202-20260114","doi-asserted-by":"crossref","first-page":"88","DOI":"10.11622\/smedj.2013089","article-title":"Intestinal torsion causing chylous ascites: a rare occurrence","volume":"54","author":"Koh","year":"2013","journal-title":"Singapore Med. J"},{"key":"R11-202-20260114","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.ijscr.2019.11.037","article-title":"Recurrent midgut volvulus in an adult patient \u2014 the case for pexy? A case report and review of the literature","volume":"66","author":"Ferreira","year":"2020","journal-title":"Int. J. Surg. Case Rep"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220311937?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220311937?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.12.004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:13:02Z","timestamp":1768396382000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.12.004"}},"subtitle":["a case report"],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":11,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2020.12.004","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}