急性虫垂炎に乳び腹水・ネフローゼ症候群を合併した1小児例

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  • A PEDIATRIC CASE OF ACUTE APPENDICITIS ASSOCIATING WITH CHYLOUS ASCITES AND NEPHROTIC SYNDROME

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We experienced a child patient who was found having a large quantity of collection of chylous ascites during laparotomy for acute appendicitis and was diagnosed as nephrotic syndrome in the postoperative course.<br> A 10-year-old boy was seen at the hospital because of abdominal pain, diarrhea, and vomiting. He was diagnosed as acute appendicitis associating with ascites and laparotomy was carried out. There were about 300ml collection of chylous ascites and gangrenous appendicitis with milk-white change of the mesenterium and lymph node swelling. The ascites had the specific gravity of 1.008 and was a Ribaruta reaction negative transudate, which showed a high level of chylomicron, 490mg/dl. After the operation inflammatory findings disappeared and discharge of chylous ascites decreased, but hypoproteinemia, exudation of urinary protein, and mild hyperlipidemia were detected in the clinical course. The patient was diagnosed as having nephrotic syndrome.<br> Probable etiology of this association of acute appendicitis, chylous ascites, and nephrotic syndrome in the patient is presented here, together with a review of the literature.

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