Drain worm

This was pulled out of a peritoneal catheter draining a patient’s ascites. Can you guess what it is?

This is actually a cast of solidified chylous ascites. It was pulled out of a dysfunctioning 10F peritoneal pigtail catheter. The regularly spaced bumps represent the sideholes of the catheter.

Chylous ascites (or chyloperitoneum) results from leakage op lipid-rich lymph into the peritoneal cavity. Usually it appears as a milky and cloudy fluid, having triglyceride levels > 200 mg/dL. At certain points (e.g. closer to room temperature) it can solidify.

Unfortunately for this patient the chylous ascites kept clogging up his drains necessitating several new catheter placements.