Chylous Ascites: Evaluation and Management

Table 1

Etiological classification of chylous ascites.

Atraumatic [2]		Traumatic
(I) Neoplastic	Cardiac	(I) Iatrogenic
Solid organ cancers	Constrictive pericarditis	(A) Surgical
Lymphoma	Congestive heart failure	Abdominal aneurysm repair
Sarcoma	Gastrointestinal	Retroperitoneal lymphadenectomy
Carcinoid tumors	Celiac sprue	Placement of peritoneal dialysis catheter
Lymphangioleiomyomatosis	Whipple’s disease	Inferior vena cava resection
Chronic lymphatic leukemia	Intestinal malrotation	Pancreaticoduodenectomy
(II) Diseases	Small bowel volvulus	Vagotomy
(A) Congenital	Ménétrier disease	Radical and laparoscopic nephrectomy
Primary lymphatic hypoplasia	Inflammatory	Nissen fundoplication
Klippel-Trenaunay syndrome	Pancreatitis	Distal splenorenal shunts
Yellow nail syndrome	Fibrosing mesenteritis	Laparoscopic adrenalectomy
Primary lymphatic hyperplasia	Retroperitoneal fibrosis	Gynecological surgery
Lymphangioma	Sarcoidosis	(B) Nonsurgical
Familial visceral myopathy	Systemic lupus erythematosus	Radiotherapy
(B) Acquired	Behçet’s disease	(II) Noniatrogenic
Cirrhosis	Peritoneal dialysis	Blunt abdominal trauma
Infectious	Hyperthyroidism	Battered child syndrome
Tuberculosis	Nephrotic syndrome	Penetrating abdominal trauma
Filariasis	Drugs	Shear forces to the root of the mesentery
Mycobacterium avium in AIDS	Calcium channel blockers	(III) Idiopathic
Ascariasis	Sirolimus	Rule out lymphoma