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Case Records of the Massachusetts General HospitalFree Preview

Case 14-2022: A 57-Year-Old Man with Chylous Ascites

List of authors.
  • Michael Dougan, M.D., Ph.D.,
  • Mark A. Anderson, M.D.,
  • Jeremy S. Abramson, M.D.,
  • and Megan J. Fitzpatrick, M.D.

A 57-year-old man was evaluated in the gastroenterology clinic because of new ascites. Paracentesis yielded milky-appearing ascitic fluid with a triglyceride level of 797 mg per deciliter. CT revealed multiple hypoenhancing liver lesions. There was a history of eosinophilic gastroenteritis and protein-losing enteropathy. A diagnostic test was performed.

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Funding and Disclosures

This case was presented at the Medicine Case Conference, Interview Series.

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

We thank Dr. Lawrence Zuckerberg for his assistance with the pathological portion of the manuscript.

Author Affiliations

From the Departments of Medicine (M.D., J.S.A.), Radiology (M.A.A.), and Pathology (M.J.F.), Massachusetts General Hospital, and the Departments of Medicine (M.D., J.S.A.), Radiology (M.A.A.), and Pathology (M.J.F.), Harvard Medical School — both in Boston.

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