Table of Contents
ISRN Hepatology
Volume 2014, Article ID 240473, 10 pages
http://dx.doi.org/10.1155/2014/240473
Review Article

Chylous Ascites: Evaluation and Management

1Hepatology Unit, Department of Gastroenterology, Royal Victoria Hospital, McGill University Health Center, Montreal, QC, Canada
2Department of Medicine, College of Medicine and Health Science, Sultan Qaboos University, P.O. Box 35, 123 Muscat, Oman

Received 28 September 2013; Accepted 19 December 2013; Published 3 February 2014

Academic Editors: D. Morioka, O. Topcu, and M. Watanabe

Copyright © 2014 Said A. Al-Busafi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. A. Cárdenas and S. Chopra, “Chylous ascites,” American Journal of Gastroenterology, vol. 97, no. 8, pp. 1896–1900, 2002. View at Publisher · View at Google Scholar · View at Scopus
  2. O. O. Aalami, D. B. Allen, and C. H. Organ Jr., “Chylous ascites: a collective review,” Surgery, vol. 128, no. 5, pp. 761–778, 2000. View at Publisher · View at Google Scholar · View at Scopus
  3. O. W. Press, N. O. Press, and S. D. Kaufman, “Evaluation and management of chylous ascites,” Annals of Internal Medicine, vol. 96, no. 3, pp. 358–364, 1982. View at Google Scholar · View at Scopus
  4. J. S. Vasko and R. I. Tapper, “The surgical significance of chylous ascites,” Archives of Surgery, vol. 95, no. 3, pp. 355–368, 1967. View at Google Scholar · View at Scopus
  5. G. J. Tortora and M. Nielsen, Principles of Human Anatomy, John Wiley & Sons, Hoboken, NJ, USA, 12th edition, 2012.
  6. J. R. Malagelada, F. L. Iber, and W. G. Linscheer, “Origin of fat in chylous ascites of patients with liver cirrhosis,” Gastroenterology, vol. 67, no. 5, pp. 878–886, 1974. View at Google Scholar · View at Scopus
  7. D. B. Zilversmit, “The composition and structure of lymph chylomicrons in dog, rat, and man,” The Journal of Clinical Investigation, vol. 44, no. 10, pp. 1610–1622, 1965. View at Google Scholar · View at Scopus
  8. G. T. Lesser, M. S. Bruno, and K. Enselberg, “Chylous ascites. Newer insights and many remaining enigmas,” Archives of Internal Medicine, vol. 125, no. 6, pp. 1073–1077, 1970. View at Publisher · View at Google Scholar · View at Scopus
  9. M. L. Paes and H. Powell, “Chylothorax: an update,” British Journal of Hospital Medicine, vol. 51, no. 9, pp. 482–490, 1994. View at Google Scholar · View at Scopus
  10. A. Blalock, C. S. Robinson, R. S. Cunningham, and M. E. Gray, “Experimental studies on lymphatic blockage,” Archives of Surgery, vol. 34, pp. 1049–1071, 1937. View at Google Scholar
  11. N. L. Browse, N. M. Wilson, F. Russo, H. Al-Hassan, and D. R. Allen, “Aetiology and treatment of chylous ascites,” British Journal of Surgery, vol. 79, no. 11, pp. 1145–1150, 1992. View at Publisher · View at Google Scholar · View at Scopus
  12. M. K. Hurley, V. J. Emiliani, G. M. Comer, A. Patel, C. Navarro, and C. O. Maiki, “Dilated cardiomyopathy associated with chylous ascites,” American Journal of Gastroenterology, vol. 84, no. 12, pp. 1567–1569, 1989. View at Google Scholar · View at Scopus
  13. S. Güneri, C. Nazli, O. Kinay, O. Kirimli, C. Mermut, and E. Hazan, “Chylous ascites due to constrictive pericarditis,” International Journal of Cardiac Imaging, vol. 16, no. 1, pp. 49–54, 2000. View at Publisher · View at Google Scholar · View at Scopus
  14. B. T. Maywood, L. Goldstein, and R. W. Busuttil, “Chylous ascites after a Warren shunt,” American Journal of Surgery, vol. 135, no. 5, pp. 700–702, 1978. View at Google Scholar · View at Scopus
  15. W. S. C. Cheng, I. R. Gough, M. Ward, J. Croese, and L. W. Powell, “Chylous ascites in cirrhosis: a case report and review of literature,” Journal of Gastroenterology and Hepatology, vol. 4, no. 1, pp. 95–99, 1989. View at Google Scholar · View at Scopus
  16. W. G. Rector Jr., “Spontaneous chylous ascites of cirrhosis,” Journal of Clinical Gastroenterology, vol. 6, no. 4, pp. 369–372, 1984. View at Google Scholar · View at Scopus
  17. D. C. Steinemann, D. Dindo, P.-A. Clavien, and A. Nocito, “Atraumatic chylous ascites: systematic review on symptoms and causes,” Journal of the American College of Surgeons, vol. 212, no. 5, pp. 899–905, 2011. View at Publisher · View at Google Scholar · View at Scopus
  18. T. Almakdisi, S. Massoud, and G. Makdisi, “Lymphomas and chylous ascites: review of the literature,” Oncologist, vol. 10, no. 8, pp. 632–635, 2005. View at Publisher · View at Google Scholar · View at Scopus
  19. V. J. Ferrans, Z. X. Yu, W. K. Nelson et al., “Lymphangioleiomyomatosis (LAM): a review of clinical and morphological features,” Journal of Nippon Medical School, vol. 67, no. 5, pp. 311–329, 2000. View at Google Scholar · View at Scopus
  20. U. Fox and G. Lucani, “Disorders of the intestinal mesenteric lymphatic system,” Lymphology, vol. 26, no. 2, pp. 61–66, 1993. View at Google Scholar · View at Scopus
  21. S. W. Unger and J. G. Chandler, “Chylous ascites in infants and children,” Surgery, vol. 93, no. 3, pp. 455–461, 1983. View at Google Scholar · View at Scopus
  22. M. Cohen Jr., “Klippel-Trenaunay syndrome,” American Journal of Medical Genetics, vol. 93, no. 3, pp. 171–175, 2000. View at Google Scholar
  23. P. M. Duhra, E. M. M. Quigley, and M. N. Marsh, “Chylous ascites, intestinal lymphangiectasia and the “yellow-nail” syndrome,” Gut, vol. 26, no. 11, pp. 1266–1269, 1985. View at Google Scholar · View at Scopus
  24. S. Sultan, A. Pauwels, R. Poupon, and V. G. Levy, “Chylous ascites in cirrhosis. A retrospective study of 20 cases,” Gastroenterologie Clinique et Biologique, vol. 14, no. 11, pp. 842–847, 1990. View at Google Scholar · View at Scopus
  25. L. Vargas-Tank, R. Estay, L. Ovalle, J. R. Soto, and M. E. Villanueva, “Esophageal sclerotherapy and chylous ascites,” Gastrointestinal Endoscopy, vol. 40, no. 3, p. 396, 1994. View at Google Scholar · View at Scopus
  26. F. M. Gómez Soto, F. Marcos Sánchez, A. I. Franco Moreno, A. Viana Alonso, A. I. Muñoz Ruiz, and A. D. Pérez-Navarro, “Chylous ascites chylosus as a manifestation of hepatocarcinoma,” Gastroenterologia y Hepatologia, vol. 26, no. 4, pp. 276–277, 2003. View at Publisher · View at Google Scholar · View at Scopus
  27. R. W. L. Leong, A. K. House, and G. P. Jeffrey, “Chylous ascites caused by portal vein thrombosis treated with octreotide,” Journal of Gastroenterology and Hepatology, vol. 18, no. 10, pp. 1211–1213, 2003. View at Publisher · View at Google Scholar · View at Scopus
  28. J. B. Mehta, A. Dutt, L. Harvill, and K. M. Mathews, “Epidemiology of extrapulmonary tuberculosis: a comparative analysis with pre-AIDS era,” Chest, vol. 99, no. 5, pp. 1134–1138, 1991. View at Google Scholar · View at Scopus
  29. M. M. Braun, R. H. Byers, W. L. Heyward et al., “Acquired immunodeficiency syndrome and extrapulmonary tuberculosis in the United States,” Archives of Internal Medicine, vol. 150, no. 9, pp. 1913–1916, 1990. View at Publisher · View at Google Scholar · View at Scopus
  30. J. M. Aguado, F. Pons, F. Casafont, G. San Miguel, and R. Valle, “Tuberculous peritonitis: a study comparing cirrhotic and noncirrhotic patients,” Journal of Clinical Gastroenterology, vol. 12, no. 5, pp. 550–554, 1990. View at Google Scholar · View at Scopus
  31. R. M. Patel and E. Purow, “Chylous ascites and chylothorax. Presenting manifestation of pancreatic carcinoma,” New York State Journal of Medicine, vol. 82, no. 3, pp. 349–351, 1982. View at Google Scholar · View at Scopus
  32. P. Phillips, J. K. Lee, C. Wang, E. Yoshida, V. D. Lima, and J. Montaner, “Chylous ascites: a late complication of intra-abdominal Mycobacterium avium complex immune reconstitution syndrome in HIV-infected patients,” International Journal of STD and AIDS, vol. 20, no. 4, pp. 285–287, 2009. View at Publisher · View at Google Scholar · View at Scopus
  33. J. P. Goldfarb, “Chylous effusions secondary to pancreatitis: case report and review of the literature,” American Journal of Gastroenterology, vol. 79, no. 2, pp. 133–135, 1984. View at Google Scholar · View at Scopus
  34. B. White, A. Kong, and A.-L. Chang, “Sclerosing mesenteritis,” Australasian Radiology, vol. 49, no. 2, pp. 185–188, 2005. View at Publisher · View at Google Scholar · View at Scopus
  35. Y. Sakai and T. Nasu, “Idiopathic retroperitoneal fibrosis,” Acta Pathologica Japonica, vol. 26, no. 5, pp. 637–647, 1976. View at Google Scholar · View at Scopus
  36. J. M. Provenza and B. R. Bacon, “Chyloperitoneum associated with sarcoidosis,” American Journal of Gastroenterology, vol. 88, no. 9, pp. 1462–1463, 1993. View at Google Scholar · View at Scopus
  37. S. B'Chir Hamzaoui, M. Abdallah, K. Bouslama et al., “Chylous ascites revealing a systemic lupus erythematosus,” Gastroenterologie Clinique et Biologique, vol. 31, no. 1, pp. 100–101, 2007. View at Google Scholar · View at Scopus
  38. C. K. Cheung and A. Khwaja, “Chylous ascites: an unsual complication of peritoneal dialysis. A case report and literature review,” Peritoneal Dialysis International, vol. 28, no. 3, pp. 229–231, 2008. View at Google Scholar · View at Scopus
  39. N. Hiroi, Y. Sakamoto, Y. Urita, M. Higa, K. Kuboki, and G. Yoshino, “Graves' disease with intractable diarrhea, chylous ascites, and chylothorax: a case report,” Thyroid, vol. 17, no. 12, pp. 1299–1303, 2007. View at Publisher · View at Google Scholar · View at Scopus
  40. R. W. England, K. W. Grathwohl, and G. E. Powell, “Constrictive pericarditis presenting as chylous ascites,” Journal of Clinical Gastroenterology, vol. 35, no. 1, pp. 104–105, 2002. View at Publisher · View at Google Scholar · View at Scopus
  41. B. Amasyali, G. Heper, O. Akkoc, U. C. Yuksel, A. Kilic, and E. Isik, “Chylous ascites and pleural effusion secondary to constrictive pericarditis presenting with signs of lymphatic obstruction,” Japanese Heart Journal, vol. 45, no. 3, pp. 535–540, 2004. View at Publisher · View at Google Scholar · View at Scopus
  42. H. A. Cakmak, G. Yenidunya, B. Karadag, and Z. Ongen, “Development of chylothorax and chylous ascites in a patient with congestive heart failure,” Türk Kardiyoloji Derneği Arşivi, vol. 39, no. 6, pp. 495–498, 2011. View at Google Scholar
  43. E. Ridruejo and O. G. Mandó, “Chylous ascites as the main manifestation of left ventricular dysfunction: a case report,” BMC Gastroenterology, vol. 5, article 25, 2005. View at Publisher · View at Google Scholar · View at Scopus
  44. M.-H. Hsieh, C.-C. Chen, T.-Y. Wang, and C.-T. Chang, “Chylous ascites as a manifestation of thyrotoxic cardiomyopathy in a patient with untreated Graves' disease,” Thyroid, vol. 20, no. 6, pp. 653–655, 2010. View at Publisher · View at Google Scholar · View at Scopus
  45. A. Kato, S. Kohno, T. Ohtake, T. Takita, and A. Hirshida, “Chylous ascites in an adult patient with nephrotic syndrome due to membranous nephropathy,” Nephron, vol. 89, no. 3, pp. 361–362, 2001. View at Publisher · View at Google Scholar · View at Scopus
  46. S. Lewsuwan, T. Kanjanabuch, Y. Avihingsanon, K. Praditpornsilpa, and S. Eiam-Ong, “A rare case of chylous ascites and chyluria in an adult nephrotic syndrome with focal segmental glomerulosclerosis,” Journal of the Medical Association of Thailand, vol. 89, supplement 2, pp. S253–S256, 2006. View at Google Scholar · View at Scopus
  47. J. Lindenbaum and S. S. Scheidt, “Chylous ascites and the nephrotic syndrome. Report of a case, associated with renal vein thrombosis,” The American Journal of Medicine, vol. 44, no. 5, pp. 830–836, 1968. View at Google Scholar · View at Scopus
  48. H. J. Kaufmann, “Chylous ascites and intestinal muscular hypertrophy occurring in the course of celiac sprue,” American Journal of Digestive Diseases, vol. 20, no. 5, pp. 494–497, 1975. View at Google Scholar · View at Scopus
  49. Y.-T. Tsao and W.-L. Chen, “Calcium channel blocker-induced chylous ascites in peritoneal dialysis,” Kidney International, vol. 75, no. 8, p. 868, 2009. View at Publisher · View at Google Scholar · View at Scopus
  50. K. Yoshimoto, S. Saima, Y. Nakamura et al., “Dihydropyridine type calcium channel blocker-induced turbid dialysate in patients undergoing peritoneal dialysis,” Clinical Nephrology, vol. 50, no. 2, pp. 90–93, 1998. View at Google Scholar · View at Scopus
  51. W.-S. Yang, J.-W. Huang, H.-W. Chen, T.-J. Tsai, and K.-D. Wu, “Lercanidipine-induced chyloperitoneum in patients on peritoneal dialysis,” Peritoneal Dialysis International, vol. 28, no. 6, pp. 632–636, 2008. View at Google Scholar · View at Scopus
  52. G. Castro, C. Freitas, I. Beirão, G. Rocha, A. C. Henriques, and A. Cabrita, “Chylous ascites in a renal transplant recipient under sirolimus (rapamycin) treatment,” Transplantation Proceedings, vol. 40, no. 5, pp. 1756–1758, 2008. View at Publisher · View at Google Scholar · View at Scopus
  53. R. Kaas, L. D. Rustman, and F. A. N. Zoetmulder, “Chylous ascites after oncological abdominal surgery: incidence and treatment,” European Journal of Surgical Oncology, vol. 27, no. 2, pp. 187–189, 2001. View at Publisher · View at Google Scholar · View at Scopus
  54. E. Olthof, J. D. Blankensteijin, and G. J. M. Akkersdijk, “Chyloperitoneum following abdominal aortic surgery,” Vascular, vol. 16, no. 5, pp. 258–262, 2008. View at Google Scholar · View at Scopus
  55. J. Baniel, R. S. Foster, R. G. Rowland, R. Bihrle, and J. P. Donohue, “Management of chylous ascites after retroperitoneal lymph node dissection for testicular cancer,” Journal of Urology, vol. 150, no. 5, part 1, pp. 1422–1424, 1993. View at Google Scholar · View at Scopus
  56. T. C. Bower, D. M. Nagorney, K. J. Cherry Jr. et al., “Replacement of the inferior vena cava for malignancy: an update,” Journal of Vascular Surgery, vol. 31, no. 2, pp. 270–281, 2000. View at Google Scholar · View at Scopus
  57. Y. Edoute, P. Nagachandran, A. Assalia, and H. Ben-Ami, “Transient chylous ascites following a distal splenorenal shunt,” Hepato-Gastroenterology, vol. 47, no. 32, pp. 531–532, 2000. View at Google Scholar · View at Scopus
  58. R. A. Weseman, “Review of incidence and management of chylous ascites after small bowel transplantation,” Nutrition in Clinical Practice, vol. 22, no. 5, pp. 482–484, 2007. View at Publisher · View at Google Scholar · View at Scopus
  59. S. Asfar, R. Lowndes, and W. J. Wall, “Chylous ascites after liver transplantation,” Transplantation, vol. 58, no. 3, pp. 368–369, 1994. View at Google Scholar · View at Scopus
  60. P. H. Y. Chung, K. K. Y. Wong, and P. K. H. Tam, “Chylous ascites following choledochal cyst excision and Ladd's procedure,” Journal of Paediatrics and Child Health, vol. 44, no. 9, pp. 526–527, 2008. View at Publisher · View at Google Scholar · View at Scopus
  61. N. A. van der Gaag, A. C. Verhaar, E. B. Haverkort, O. R. C. Busch, T. M. van Gulik, and D. J. Gouma, “Chylous ascites after pancreaticoduodenectomy: introduction of a grading system,” Journal of the American College of Surgeons, vol. 207, no. 5, pp. 751–757, 2008. View at Publisher · View at Google Scholar · View at Scopus
  62. I.-C. Su and C.-M. Chen, “Spontaneous healing of retroperitoneal chylous leakage following anterior lumbar spinal surgery: a case report and literature review,” European Spine Journal, vol. 16, supplement 3, pp. S332–S337, 2007. View at Publisher · View at Google Scholar · View at Scopus
  63. T. S. Bacelar, A. C. de Albuquerque, P. C. de Arruda, A. A. Ferraz, and E. M. Ferraz, “Postoperative chylous ascites: a rare complication of laparoscopic Nissen fundoplication,” JSLS, vol. 7, no. 3, pp. 269–271, 2003. View at Google Scholar
  64. J. E. Hidalgo, A. Ramirez, S. Patel et al., “Chyloperitoneum after laparoscopic Roux-en-Y gastric bypass (LRYGB),” Obesity Surgery, vol. 20, no. 2, pp. 257–260, 2010. View at Publisher · View at Google Scholar · View at Scopus
  65. P. de Sousa, L. Viart, J. Petit, and F. Saint, “Chylous ascites after laparoscopic adrenalectomy trans-peritoneal: anatomical distribution of lymph nodes and management,” Progres en Urologie, vol. 20, no. 5, pp. 385–388, 2010. View at Publisher · View at Google Scholar · View at Scopus
  66. E. H. Jensen and C. A. Weiss III, “Management of chylous ascites after laparoscopic cholecystectomy using minimally invasive techniques: a case report and literature review,” American Surgeon, vol. 72, no. 1, pp. 60–63, 2006. View at Google Scholar · View at Scopus
  67. J. Aerts, A. Matas, D. Sutherland, and R. Kandaswamy, “Chylous ascites requiring surgical intervention after donor nephrectomy: case series and single center experience,” American Journal of Transplantation, vol. 10, no. 1, pp. 124–128, 2010. View at Publisher · View at Google Scholar · View at Scopus
  68. S. S. Lentz, M. F. Schray, and T. O. Wilson, “Chylous ascites after whole-abdomen irradiation for gynecologic malignancy,” International Journal of Radiation Oncology, Biology, Physics, vol. 19, no. 2, pp. 435–438, 1990. View at Google Scholar · View at Scopus
  69. P. A. Hurst and J. M. Edwards, “Chylous ascites and obstructive lymphoedema of the small bowel following abdominal radiotherapy,” British Journal of Surgery, vol. 66, no. 11, pp. 780–781, 1979. View at Google Scholar · View at Scopus
  70. Y.-K. Keung, R. P. Whitehead, and E. Cobos, “Chemotherapy treatment of chyloperitoneum and peritoneal carcinomatosis due to cervical cancer—review of literature,” Gynecologic Oncology, vol. 61, no. 3, pp. 448–450, 1996. View at Publisher · View at Google Scholar · View at Scopus
  71. J. M. Haan, S. Montgomery, T. J. Novosel, D. M. Stein, and T. M. Scalea, “Chyloperitoneum after blunt abdominal injury,” American Surgeon, vol. 73, no. 8, pp. 811–813, 2007. View at Google Scholar · View at Scopus
  72. J. M. Plummer, M. E. McFarlane, and A. H. McDonald, “Chylous ascites associated with chylothorax; a rare sequela of penetrating abdominal trauma: a case report,” Journal of Medical Case Reports, vol. 1, article 49, 2007. View at Publisher · View at Google Scholar · View at Scopus
  73. A. L. Beal, C. M. Gormley, D. L. Gordon, and C. M. C. Ellis, “Chylous ascites: a manifestation of blunt abdominal trauma in an infant,” Journal of Pediatric Surgery, vol. 33, no. 4, pp. 650–652, 1998. View at Publisher · View at Google Scholar · View at Scopus
  74. P. J. Gaglio, C. B. Leevy, and B. Koneru, “Peri-operative chylous ascites,” Journal of Medicine, vol. 27, no. 5-6, pp. 369–376, 1996. View at Google Scholar · View at Scopus
  75. M. R. Camiel, D. L. Benninghoff, and L. L. Alexander, “Chylous effusions, extravasation of lymphographic contrast material, hypoplasia of lymph nodes and lymphocytopenia,” Chest, vol. 59, no. 1, pp. 107–110, 1971. View at Google Scholar · View at Scopus
  76. M. D. Taylor, S. S. Kim, and L. J. Vaias, “Therapeutic digoxin level in chylous drainage with no detectable plasma digoxin level,” Chest, vol. 114, no. 5, pp. 1482–1484, 1998. View at Google Scholar · View at Scopus
  77. C. Strange, D. P. Nicolau, and S. R. Dryzer, “Chylous transport of amiodarone,” Chest, vol. 101, no. 2, pp. 573–574, 1992. View at Google Scholar · View at Scopus
  78. R. Repp, H. H. Scheld, J. Bauer, H. Becker, J. Kreuder, and H. Netz, “Cyclosporine losses by a chylothorax,” Journal of Heart and Lung Transplantation, vol. 11, no. 2, pp. 397–398, 1992. View at Google Scholar · View at Scopus
  79. B. A. Runyon, E. A. Akriviadis, and A. J. Keyser, “The opacity of portal hypertension-related ascites correlates with the fluid's triglyceride concentration,” American Journal of Clinical Pathology, vol. 96, no. 1, pp. 142–143, 1991. View at Google Scholar · View at Scopus
  80. B. A. Runyon, “Management of adult patients with ascites due to cirrhosis: an update,” Hepatology, vol. 49, no. 6, pp. 2087–2107, 2009. View at Publisher · View at Google Scholar · View at Scopus
  81. A. Riquelme, M. Calvo, F. Salech et al., “Value of adenosine deaminase (ADA) in ascitic fluid for the diagnosis of tuberculous peritonitis: a meta-analysis,” Journal of Clinical Gastroenterology, vol. 40, no. 8, pp. 705–710, 2006. View at Publisher · View at Google Scholar · View at Scopus
  82. D. J. Hillebrand, B. A. Runyon, W. G. Yasmineh, and G. P. Rynders, “Ascitic fluid adenosine deaminase insensitivity in detecting tuberculous peritonitis in the United States,” Hepatology, vol. 24, no. 6, pp. 1408–1412, 1996. View at Publisher · View at Google Scholar · View at Scopus
  83. J. M. Martinez-Vazquez, I. Ocana, E. Ribera, R. M. Segura, and C. Pascual, “Adenosine deaminase activity in the diagnosis of tuberculous peritonitis,” Gut, vol. 27, no. 9, pp. 1049–1053, 1986. View at Google Scholar · View at Scopus
  84. B. A. Runyon, “Current concepts: care of patients with ascites,” The New England Journal of Medicine, vol. 330, no. 5, pp. 337–342, 1994. View at Publisher · View at Google Scholar · View at Scopus
  85. J. F. Hibbeln, M. D. Wehmueller, and A. C. Wilbur, “Chylous ascites: CT and ultrasound appearance,” Abdominal Imaging, vol. 20, no. 2, pp. 138–140, 1995. View at Publisher · View at Google Scholar · View at Scopus
  86. D. L. Day and W. J. Warwick, “Thoracic duct opacification for CT scanning,” American Journal of Roentgenology, vol. 144, no. 2, pp. 403–404, 1985. View at Google Scholar · View at Scopus
  87. M. H. Pui and T.-C. Yueh, “Lymphoscintigraphy in chyluria, chyloperitoneum and chylothorax,” Journal of Nuclear Medicine, vol. 39, no. 7, pp. 1292–1296, 1998. View at Google Scholar · View at Scopus
  88. J. T. Andrews and L. J. Binder, “Lymphoscintigraphy pre- and post-surgical lymphatic leak repair,” Australasian Radiology, vol. 40, no. 1, pp. 19–21, 1996. View at Google Scholar · View at Scopus
  89. P. B. Sachs, M. G. Zelch, T. W. Rice, M. A. Geisinger, B. Risius, and G. K. Lammert, “Diagnosis and localization of laceration of the thoracic duct: usefulness of lymphangiography and CT,” American Journal of Roentgenology, vol. 157, no. 4, pp. 703–705, 1991. View at Google Scholar · View at Scopus
  90. C. Cope, “Diagnosis and treatment of postoperative chyle leakage via percutaneous transabdominal catheterization of the cisterna chyli: a preliminary study,” Journal of Vascular and Interventional Radiology, vol. 9, no. 5, pp. 727–734, 1998. View at Google Scholar · View at Scopus
  91. S. Kohnoe, I. Takahashi, H. Kawanaka, M. Mori, K. Okadome, and K. Sugimachi, “Combination of preoperative lymphangiography using lipiodol and intraoperative lymphangiography using Evans Blue facilitates the accurate identification of postoperative chylous fistulas,” Surgery Today, vol. 23, no. 10, pp. 929–931, 1993. View at Google Scholar · View at Scopus
  92. T. Matsumoto, T. Yamagami, T. Kato et al., “The effectiveness of lymphangiography as a treatment method for various chyle leakages,” British Journal of Radiology, vol. 82, no. 976, pp. 286–290, 2009. View at Publisher · View at Google Scholar · View at Scopus
  93. M. J. Nube, P. H. J. Slee, G. H. Ooms, and K. J. Heering, “Lymphoedema and chylo ascites; an unusual complication of lymphography,” Netherlands Journal of Medicine, vol. 20, no. 1, pp. 18–22, 1977. View at Google Scholar · View at Scopus
  94. C. J. Ablan, F. N. Littooy, and R. J. Freeark, “Postoperative chylous ascites: diagnosis and treatment. A series report and literature review,” Archives of Surgery, vol. 125, no. 2, pp. 270–273, 1990. View at Google Scholar · View at Scopus
  95. J. B. Kinmonth, “Disorders of the circulation of chyle,” Journal of Cardiovascular Surgery, vol. 17, no. 4, pp. 329–339, 1976. View at Google Scholar · View at Scopus
  96. A. Smoke and M. H. Delegge, “Chyle leaks: consensus on management?” Nutrition in Clinical Practice, vol. 23, no. 5, pp. 529–532, 2008. View at Publisher · View at Google Scholar · View at Scopus
  97. C. R. Parrish and S. McCray, “When chyle leaks: nutrition management options,” Practical Gastroenterology, vol. 28, no. 5, pp. 60–76, 2004. View at Google Scholar · View at Scopus
  98. S. K. Ohri, T. Patel, L. A. Desa, and J. Spencer, “The management of postoperative chylous ascites. A case report and literature review,” Journal of Clinical Gastroenterology, vol. 12, no. 6, pp. 693–697, 1990. View at Google Scholar · View at Scopus
  99. J. Uriz, A. Cárdenas, and V. Arroyo, “Pathophysiology, diagnosis and treatment of ascites in cirrhosis,” Baillière's Best Practice & Research. Clinical Gastroenterology, vol. 14, no. 6, pp. 927–943, 2000. View at Publisher · View at Google Scholar · View at Scopus
  100. S. Akbulut, D. Yilmaz, S. Bakir, E. Cucuk, and M. Tas, “Acute appendicitis together with chylous ascites: is it a coincidence?” Case Reports in Medicine, vol. 2010, Article ID 206860, 4 pages, 2010. View at Google Scholar
  101. B. S. Karagol, A. Zenciroglu, S. Gokce, A. A. Kundak, and M. S. Ipek, “Therapeutic management of neonatal chylous ascites: report of a case and review of the literature,” Acta Paediatrica, vol. 99, no. 9, pp. 1307–1310, 2010. View at Publisher · View at Google Scholar · View at Scopus
  102. J. Chen, R. K. Lin, and T. Hassanein, “Use of orlistat (xenical) to treat chylous ascites,” Journal of Clinical Gastroenterology, vol. 39, no. 9, pp. 831–833, 2005. View at Publisher · View at Google Scholar · View at Scopus
  103. A. E. Yildirim, R. Altun, S. Can et al., “Idiopathic chylous ascites treated with total parenteral nutrition and octreotide. A case report and review of the literature,” European Journal of Gastroenterology and Hepatology, vol. 23, no. 10, pp. 961–963, 2011. View at Publisher · View at Google Scholar · View at Scopus
  104. G. Joanny, A. Celia, G. Zeccolini, D. Del Biondo, and G. Breda, “Chylous ascites following laparoscopic adrenalectomy: case report and literature review,” Archivio Italiano di Urologia e Andrologia, vol. 82, no. 3, pp. 186–188, 2010. View at Google Scholar · View at Scopus
  105. D. X. Zhou, H. B. Zhou, Q. Wang, S. S. Zou, H. Wang, and H. P. Hu, “The effectiveness of the treatment of octreotide on chylous ascites after liver cirrhosis,” Digestive Diseases and Sciences, vol. 54, no. 8, pp. 1783–1788, 2009. View at Publisher · View at Google Scholar · View at Scopus
  106. G. Baiocchi, C. C. Faloppa, R. L. C. Araujo et al., “Chylous ascites in gynecologic malignancies: cases report and literature review,” Archives of Gynecology and Obstetrics, vol. 281, no. 4, pp. 677–681, 2010. View at Publisher · View at Google Scholar · View at Scopus
  107. A. Widjaja, K. F. Gratz, J. Ockenga, S. Wagner, and M. P. Manns, “Octreotide for therapy of chylous ascites in yellow nail syndrome,” Gastroenterology, vol. 116, no. 4, pp. 1017–1018, 1999. View at Google Scholar · View at Scopus
  108. P. Guillem, V. Billeret, M. L. Houcke, and J. P. Triboulet, “Successful management of post-esophagectomy chylothorax/chyloperitoneum by etilefrine,” Diseases of the Esophagus, vol. 12, no. 2, pp. 155–156, 1999. View at Publisher · View at Google Scholar · View at Scopus
  109. G. J. de Vries, B. M. Ryan, M. De Bièvre, A. Driessen, R. W. Stockbrugger, and G. H. Koek, “Cirrhosis related chylous ascites successfully treated with TIPS,” European Journal of Gastroenterology and Hepatology, vol. 17, no. 4, pp. 463–466, 2005. View at Publisher · View at Google Scholar · View at Scopus
  110. T. B. Kinney, S. L. Ferrara, F. J. Miller, A. C. Roberts, and T. Hassanein, “Transjugular intrahepatic portosystemic shunt creation as treatment for refractory chylous ascites and chylothorax in a patient with cirrhosis,” Journal of Vascular and Interventional Radiology, vol. 15, no. 1, part 1, pp. 85–89, 2004. View at Google Scholar · View at Scopus
  111. B. G. Rosser, J. J. Poterucha, M. A. McKusick, and P. S. Kamath, “Thoracic duct-cutaneous fistula in a patient with cirrhosis of the liver: successful treatment with a transjugular intrahepatic portosystemic shunt,” Mayo Clinic Proceedings, vol. 71, no. 8, pp. 793–796, 1996. View at Google Scholar · View at Scopus
  112. D. Rubinstein, I. McInnes, and F. Dudley, “Morbidity and mortality after peritoneovenous shunt surgery for refractory ascites,” Gut, vol. 26, no. 10, pp. 1070–1073, 1985. View at Google Scholar · View at Scopus
  113. D. Voros and S. Hadziyannis, “Successful management of postoperative chylous ascites with a peritoneojugular shunt,” Journal of Hepatology, vol. 22, no. 3, p. 380, 1995. View at Publisher · View at Google Scholar · View at Scopus
  114. D. Mittleider, T. A. Dykes, K. P. Cicuto, S. M. Amberson, and C. R. Leusner, “Retrograde cannulation of the thoracic duct and embolization of the cisterna chyli in the treatment of chylous ascites,” Journal of Vascular and Interventional Radiology, vol. 19, no. 2, part 1, pp. 285–290, 2008. View at Publisher · View at Google Scholar · View at Scopus
  115. F. Benedix, H. Lippert, and F. Meyer, “Post-surgical lymphocutaneous fistula, chylous ascites and chylothorax—infrequent but serious complications: etiology, diagnosis and therapeutic options review,” Zentralblatt für Chirurgie, vol. 132, no. 6, pp. 529–538, 2007. View at Publisher · View at Google Scholar · View at Scopus
  116. H. Aoki, N. Takakura, S. Shiozaki, and H. Matsukawa, “Milk-based test as a preventive method for chylous ascites following pancreatic resection,” Digestive Surgery, vol. 27, no. 5, pp. 427–432, 2010. View at Publisher · View at Google Scholar · View at Scopus
  117. S. Zeidan, A. Delarue, A. Rome, and B. Roquelaure, “Fibrin glue application in the management of refractory chylous ascites in children,” Journal of Pediatric Gastroenterology and Nutrition, vol. 46, no. 4, pp. 478–481, 2008. View at Publisher · View at Google Scholar · View at Scopus
  118. B. Antao, D. Croaker, and R. Squire, “Successful management of congenital chyloperitoneum with fibrin glue,” Journal of Pediatric Surgery, vol. 38, no. 11, pp. E7–E8, 2003. View at Google Scholar · View at Scopus