LAUSR

the duodenojejunal flexure to the right of the midline, in keeping with malrotation. The patient was taken for a laparotomy. Together with chylous ascites, a mesenteric lymphatic obstruction (Fig, A) associated with intestinal malrotation without volvulus was found. Upon performing a Ladd’s procedure, the chylous lymphatics within the cecum dissipated (Fig, B). An inversion appendectomy was also performed. No reaccumulation of ascites was seen, and the patient was discharged home on full enteral feeds after 5 days. Few case reports in the literature describe the association of chylous ascites and malrotation, likely due to volvulus or, in its absence, to the weight of the bowel loops, which increases the lymphatic pressure and contributes to the leakage of chyle into the peritoneum. Once the volvulus is treated operatively or the adhesions are divided, the chylous ascites resolves.