Laparoscopic finding of chylous ascites and intestinal malrotation in an infant presenting with left inguinal hernia.

This case report illustrates an unexpected advantage of using the laparoscopic approach for inguinal hernia repair in infants. In this paper, we report an infant referred to us with a diagnosis of an irreducible left inguinal hernia. He presented with a 1-day history of bilious vomiting and poor weight gain on breastfeeding. On arrival, a reducible left inguinal hernia was found and he was scheduled to have a laparoscopic inguinal hernia repair. During laparoscopy, chylous ascites was noted and the transverse colon and appendix could not be visualized. This raised the suspicion of malrotation with obstruction, which was confirmed on an upper gastrointestinal contrast study. He was taken back to the operating theater and a malrotation with volvulus was confirmed at laparotomy. A Ladd's procedure was performed, and he made an uneventful recovery.