CHYLE IN HERNIAL SAC IN CHYLOUS ASCITES IN 47 YEARS OLD MALE FROM CHENNAI, INDIA

We present case of a 47 year male, who underwent elective surgical repair for inguinal hernia. During surgery, chyle was unexpectedly found in the hernia sac and abdominal cavity. A thorough diagnostic workup for chylous ascites was performed to rule out pre-existent underlying pathologies, and the patient was temporarily placed on a medium-chain triglyceride diet. No symptoms occurred afterwards. Based on the clinical course and results of additional investigations, this rare phenomenon has most likely occurred due to obstruction and potential rupture of lymphatic structures due to mechanical effects following intermittent incarceration and subsequent repetitive manual reduction of the symptomatic hernia including bowel loops as content of the hernia sac. A search was made and chylous ascites as hernial content was not reported in adults. This is a rare instance.