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Bhardwaj R, Vaziri H, Gautam A, et al. Chylous Ascites: A Review of Pathogenesis, Diagnosis and Treatment. J Clin Transl Hepatol. 2017;6(1):105-113doi: 10.14218/JCTH.2017.00035.
Bhardwaj, R., Vaziri, H., Gautam, A., Ballesteros, E., Karimeddini, D., & Wu, G. Y. (2018). Chylous Ascites: A Review of Pathogenesis, Diagnosis and Treatment. Journal of clinical and translational hepatology, 6(1), 105-113. https://doi.org/10.14218/JCTH.2017.00035
Bhardwaj, Richa, et al. "Chylous Ascites: A Review of Pathogenesis, Diagnosis and Treatment." Journal of clinical and translational hepatology vol. 6,1 (2018): 105-113. doi: https://doi.org/10.14218/JCTH.2017.00035
Bhardwaj R, Vaziri H, Gautam A, Ballesteros E, Karimeddini D, Wu GY. Chylous Ascites: A Review of Pathogenesis, Diagnosis and Treatment. J Clin Transl Hepatol. 2018 Mar 28;6(1):105-113. doi: 10.14218/JCTH.2017.00035. Epub 2017 Dec 04. PMID: 29577037; PMCID: PMC5863006.
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J Clin Transl Hepatol. 2018 Mar 28;6(1):105-113. doi: 10.14218/JCTH.2017.00035. Epub 2017 Dec 04.

Chylous Ascites: A Review of Pathogenesis, Diagnosis and Treatment.

Journal of clinical and translational hepatology

Richa Bhardwaj, Haleh Vaziri, Arun Gautam, Enrique Ballesteros, David Karimeddini, George Y Wu

Affiliations

  1. Department of Medicine, Division of Gastroenterology-Hepatology, UCONN Health, Farmington, CT, USA.
  2. Department of Pathology and Lab Medicine, UCONN Health, Farmington, CT, USA.
  3. Department of Diagnostic Imaging and Therapeutics, UCONN Health, Farmington, CT, USA.

PMID: 29577037 PMCID: PMC5863006 DOI: 10.14218/JCTH.2017.00035

Abstract

Chylous ascites (CA) is a rare form of ascites that results from the leakage of lipid-rich lymph into the peritoneal cavity. This usually occurs due to trauma and rupture of the lymphatics or increased peritoneal lymphatic pressure secondary to obstruction. The underlying etiologies for CA have been classified as traumatic, congenital, infectious, neoplastic, postoperative, cirrhotic or cardiogenic. Since malignancy and cirrhosis account for about two-thirds of all the cases of CA in Western countries, in this article we have attempted to reclassify CA based on portal and non-portal etiologies. The diagnosis of CA is based on the distinct characteristic of the ascitic fluid which includes a milky appearance and a triglyceride level of >200 mg/dL. The management consists of identifying and treating the underlying disease process, dietary modification, and diuretics. Some studies have also supported the use of agents such as orlistat, somatostatin, octreotide and etilefrine. Paracentesis and surgical interventions in the form of transjugular intrahepatic portosystemic shunt (commonly known as TIPS), peritoneal shunt, angiography with embolization of a leaking vessel, and laparotomy remain as treatment options for cases refractory to medical management.

Keywords: Ascitic fluid; Chylous ascites; Cirrhosis; Lymphatic system; Portal hypertension

Conflict of interest statement

The authors have no conflict of interests related to this publication.

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