Chylous Ascites Revealing Intestinal Malrotation with Ladd's Bands in a 4-Month-Old Infant: A Case Report and Literature Review

Background: Intestinal malrotation is a congenital anomaly that may present with bowel obstruction in infancy. Chylous ascites associated with malrotation is rare.Case presentation: A 4-month-old infant presented with bilious vomiting, abdominal pain, paroxysmal crying, abdominal distension, and cessation of stool and gas passage. Ultrasound suggested intussusception. Exploratory laparotomy revealed a Ladd’s band compressing the duodenum, malrotation with fixation defect, multiple mesenteric lymph nodes, and chylous peritoneal effusion. Ladd’s procedure and appendectomy were performed. Outcome was favorable.Conclusion: Chylous ascites may be an unusual manifestation of intestinal malrotation and should be recognized during surgical exploration.