Abdominal nonchylous lymphorrhea caused by trauma

Lymphorrhea is a rare but intractable lymphatic system disease characterized by the leakage of lymph from the lymphatic system into the body cavity. Abdominal lymphorrhea is classified into two types, chylous and nonchylous, related to the source of the leak. We report the case of a 40-year-old male who developed abdominal lymphorrhea after car accident injuries. To our best knowledge, this is the first report of abdominal lymphorrhea caused by nonsurgical trauma. The diagnosis of this case was convoluted. At first the abdominal drainage fluid appeared pale bloody, not the typical celiac appearance of lymphatic leakage, constituting a difficult diagnosis. However, with the advent of changes in ascites drainage volume associated with fasting, we were starting to suspect a nonchylous lymphorrhea. Besides, persistently low lymphocytes in the blood were also a sign. Finally, the positive result of qualitative urine coeliac test confirmed our suspicions. The patient underwent treatments including multiple abdominal puncture drainage, diet management, fluid therapy, and so on. With nonsurgical treatment, the patient finally resumed enteral nutrition and the symptoms of ascites resolved.