Milky Mesentery: Acute Abdomen with Chylous Ascites

Background Clinical presentations of intestinal lymphangiectasia include pitting edema, chylous ascites, pleural effusion, diarrhea, malabsorption and intestinal obstruction. Case Characteristics An 8-year-old male child presented to the emergency department with clinical features of peritonitis, raising suspicion of appendicular or small bowel perforation. Intervention/Outcome Diagnosis of chylous ascites with primary intestinal lymphangiectasia made on laparotomy. Message Acute peritonitis may be a presentation of primary intestinal lymphangiectasia and chylous ascites.