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2428 pages added, reviewed or updated during the last month (last updated: 23/4/2021)


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chylous ascites

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Chylous ascites usually occurs when there is massive obstruction of abdominal lymphatic drainage. It is a milky white ascites, rich in chylomicrons from mesenteric lymphatics.

It is usually secondary to malignant involvement of the para-aortic lymph nodes by lymphoma or metastatic testicular tumour.

Less frequently, it is caused by:

  • primary fistula - the fistula should be closed with nonabsorbable sutures
  • primary lymphatic disease
  • other secondary causes:
    • postradiation obstruction
    • postoperative - very rarely

Treatment is surgical. Primary fistulas where present should be closed with nonabsorbable sutures. When surgery is unsuccessful, a Leveen peritoneal venous shunt should be employed to return accumulated peritoneal lymph to the central circulation.

Last reviewed 01/2018

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