Delayed Post-pancreaticoduodenectomy Chylous Ascites: A Case of Cisterna Chyli Leak Managed With Lymphatic Embolization

Chyloperitoneum is a rare cause of ascites that results from the leakage of lipid-rich lymph into the abdominal cavity. Numerous etiologies can cause chylous ascites, with the most common causes being malignancy, cirrhosis, infection, and post-procedural lymphatic duct injury in adults. We describe a case of delayed chylous ascites formation after a pancreaticoduodenectomy (Whipple) procedure with lymphocele formation and slow leakage into the peritoneal cavity. Prompt recognition and diagnosis are paramount given the high mortality rate, and the management of this condition includes treating the underlying cause, symptom management, nutritional modification, and, in select cases, surgical interventions such as embolization.