Chylous ascites is the extravasation of milky chyle into the peritoneal cavity. This can occur de novo as a result of trauma or obstruction of the lymphatic system. Moreover, an existing clear ascitic fluid can turn chylous as a secondary event.

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Chylous ascites is an uncommon clinical condition that occurs as a result of disruption of the abdominal lymphatics. Multiple causes have been described, including the following:

  • Abdominal surgery
  • Blunt abdominal trauma
  • Malignant neoplasms – Hepatoma, small bowel lymphoma, small bowel angiosarcoma, and retroperitoneal lymphoma
  • Spontaneous bacterial peritonitis
  • Cirrhosis – Up to 0.5% of patients with ascites from cirrhosis may have chylous ascites.
  • Pelvic irradiation
  • Peritoneal dialysis
  • Abdominal tuberculosis
  • Carcinoid syndrome
  • Congenital defects of lacteal formation
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