Chylous Peritonitis and Chylothorax Presenting with Acute Abdomen after Heavy Lifting

Acute abdominal pain with signs and symptoms of peritonitis due to sudden extravasation of chyle into the peritoneal cavity is a rare condition often mistaken for other disorders. Diagnosis is rarely definite preoperatively. Acute chylous peritonitis is generally idiopathic and diagnosed with laparoscopy or laparotomy. Intra-abdominal lavage and drainage are often used as treatment methods. We report a case of spontaneous chylous peritonitis due to elevated intra-abdominal pressure, which was diagnosed intraoperatively by observation of chylous fluid leakage from the retroperitoneum. The patient was treated with peritoneal lavage and drainage with primary suture ligation at the level of leakage.