Abstract
Chylous ascites (CA) is the pathological accumulation of lymphatic fluid in the peritoneal cavity. The ascitic fluid has a high concentration of triglycerides and chylomicrons, giving it a milky appearance. Owing to its infrequent diagnosis, there is limited literature describing the workup and treatment of idiopathic chylous ascites (ICA). This report describes the case of a 39-year-old woman who presented with undifferentiated abdominal pain, with the investigations leading to a diagnosis of ICA and interventions which led to complete resolution of symptoms over a follow-up period of eight months. We propose a systematic method to exclude alternative causes of chyle leak, thus aiding in the diagnosis of ICA.