Some time ago, we admitted a patient with alcoholic cirrhosis combined with ascites. When he was first admitted, he was depressed and often looked at the doctors and nurses with suspicion. It turned out that more than two months ago he was hospitalized in a general hospital for hypersplenism, and he was proposed to undergo splenectomy + dissection, but due to the adhesion of the spleen to the peritoneum, the operation was not done, and within a few days a lot of ascites appeared again, with high abdominal distension, and he was afraid to eat even if he wanted to eat. He was getting thinner and lazier, and finally the doctor came to the conclusion that you have persistent ascites and must be treated in a specialist hospital. That’s how he was transferred to our hospital. After admission, we first considered that the causes of cirrhosis combined with intractable ascites could be infection, hypoproteinemia, severe portal hypertension hellip;hellip; but this patient’s ascites was very special, similar to peach juice-like ascites caused everyone to be alert, could it be celiac ascites? So we searched the literature related to celiac ascites and found that surgery may be a predisposing factor for celiac ascites, and the main cause of this celiac ascites is damaged lymphatic vessels and leakage of lymphatic fluid into the abdominal cavity; if the injured lymphatic vessels can be repaired, the ascites can be absorbed. The most important diagnostic indicators are ascites triglycerides ≥200mg/dl, protein content about half of plasma, and ascites leukocytosis, predominantly lymphocytes. Further refinement of ascites triglycerides and other tests confirmed our suspicions: this was a typical case of celiac ascites. The lymphatic flow in the lymphatic vessels is strongly related to the fat content of the food, and usually increases 100-fold to 200 ml/kg per hour after a high-fat meal; dietary conversion of long-chain triglycerides to monoglycerides and free fatty acids, which form mainly celiac particles transported through the intestinal lymphatic vessels. In contrast, medium-chain triglycerides are absorbed directly by intestinal cells and transported to the liver as free fatty acids and glycerol via the portal vein, and a low-fat diet using medium-chain fatty triglycerides reduces celiac production and flow. Thus diet therapy as the primary non-surgical treatment for celiac ascites significantly reduces lymphatic flow and promotes healing of lymphatic fistulae. Growth inhibitors can be used for celiac leakage after thoracic and abdominal surgery, and it has been reported in the literature that intravenous application of growth inhibitors for 24 to 72 hours significantly reduces lymphatic leakage in post-surgical celiac disease. Therefore, together with the dietitian, we formulated a nutritional meal for the patient with strictly limited fat intake to reduce abdominal lymphatic fluid production, and at the same time applied growth inhibitor octreotide subcutaneously to inhibit lymphatic fluid secretion, patiently explained the condition during the checkup, encouraged the patient to actively cooperate with the treatment, combined with oral diuretics, intermittent release of ascites and other measures, the patient’s previous puncture eye healed quickly, weight and abdominal circumference gradually decreased, and he Often full of smiles, stroking his belly, happy to say: I now like to touch the belly, really comfortable! ”, we were all amused by him laughing. After more than a month of careful treatment, the patient’s ascites was completely absorbed, after the ultrasound, he said: I’m liberated, are four months did not go home, finally can go home. ” Before discharge, he repeatedly said he wanted to invite everyone to dinner, although we declined the patient’s banquet, but when we think of the patient’s sincere thanks and bright smile, we can’t help but also smile, as the white angel of pride arises, at this time feel that every day’s hard work is worth it, the patient’s smile is our best reward.