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Saudi Journal of Kidney Diseases and Transplantation
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CASE RECORD Table of Contents   
Year : 2016  |  Volume : 27  |  Issue : 2  |  Page : 386-390
Successful management of chylous ascites: A report of two cases


1 Department of Student Affairs, University College of Medical Sciences, New Delhi, India
2 Department of Student Affairs, Lake Erie College of Osteopathic Medicine, Bradenton, USA
3 Department of Nephrology, Veterans Affairs Medical Center, Orlando, Florida, USA

Correspondence Address:
Pran M Kar
Department of Nephrology, Veterans Affairs Medical Center, Orlando, Florida
USA
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DOI: 10.4103/1319-2442.178573

PMID: 26997396

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Chylous ascites consists of the accumulation of chyle in the peritoneal cavity. Diagnosis is established by cytochemical analysis of the fluid revealing fat globules and high triglyceride content. The majority of cases are caused by pathology that interferes with abdominal retroperitoneal lymphatic drainage. We present two cases of postoperative chylous ascites, one following a bilateral nephrectomy, the other following orthotopic heart transplantation. Treatment is typically conservative with the aim to alleviate abdominal distension and reduce the flow of lymph into the mesenteric lymph nodes. Postsurgical chylous ascites has high cure rate with conservative therapy alone. Therapeutic paracentesis, diuretics, salt restriction, a high-protein, low-fat, mediumchain triglyceride diet, and parenteral nutrition are considered in chronic cases. The effects of longterm paracentesis on patients remains to be seen. In patients requiring renal replacement therapy, removal of chyle during peritoneal dialysis is often attempted.


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