Chylous ascites is a rare complication following bariatric surgeries. Little data is available regarding chylous ascites following bariatric surgeries per se or in association with internal hernias. Herein we present two cases of chylous ascites following Roux-En-Y gastric bypass; the first one is a 60-year-old male who was presented to the ER six months after a gastric bypass operation suffering from abdominal pain, CT scan and upper endoscopy were normal, however chylous ascites and internal hernia were found during exploratory laparoscopy. The second case is a 39-year-old female patient who was admitted three years following the gastric bypass operation and diagnosed to have small bowel obstruction due to internal hernia, and during exploratory laparoscopy a chylous ascites was found.
Abdominal Pain ; Adult ; Bariatric Surgery ; Chylous Ascites ; Endoscopy ; Female ; Gastric Bypass ; Hernia ; Humans ; Laparoscopy ; Male ; Middle Aged ; Tomography, X-Ray Computed

Purpose: This study aimed to evaluate the outcomes of the Bascom cleft lift (flap) and the pilonidal pits excision (Gips procedure). Methods: The records of all the patients who underwent pilonidal sinus excision between November 2013 and August 2017 were reviewed. Inclusion criteria included either pilonidal pits excision or the Bascom cleft lift procedure. All procedures were performed by a single surgeon. Perioperative complications and recurrence rates were reviewed. Results: Fifty-three patients met the inclusion criteria. Male/female ratio was 36/17, with a mean age of 23.4 ± 7 years. In this study, 21 patients underwent the Bascom cleft lift (skin flap) procedure and 32 underwent the Gips-style operation. The mean follow-up was 3.5 months. Twenty-eight patients (52.8%) underwent prior drainage of pilonidal abscess. Eleven patients had a previous wide local excision with recurrent disease. A higher rate of recurrence was observed among patients who underwent pits picking following failure of a previous wide local excision (80% vs. 0%, P = 0.02). Minor wound dehiscence developed in 8 patients; all of which were in the Bascom flap group (40% vs. 0%, P < 0.005). All of these wounds healed completely between 3 and 6 weeks. Conclusion The Gips procedure is the recommended treatment for simple pilonidal disease. For recurrent pilonidal disease, the Bascom cleft lift (flap) procedure is an excellent option since it demonstrates a short wound healing time and a good success rate. This calls into question the continued use of the wide excision technique used by most surgeons in this country and abroad.