[The diagnosis and therapy of chylous ascites].
OBJECTIVE
To discuss the diagnosis and therapy of chylous ascites.


METHODS
To diagnose 40 patients of chylous ascite with regular test and quantitative analysis of chyle, direct lymphangiography, CT (immediately after direct lymphangiography), lymphangioscintigraphy, MRI. Twenty-two patients received conservative therapy, 18 patients received retroperitoneal lymphangiectomy and (or) lymph-vein shunting.


RESULTS
Lymphatic dysplasia and chylous reflux were found in almost every patient, total parenteral nutrition showed good results. Followed up from 1 month to 5 years, in conservative therapy group, 9 patients were controlled well clinically, the condition of 6 patients was improved better. Seven patients showed no effect. In operation group, 11 patients were controlled well clinically. Four patients got mitigated. Total 7 patients died, although 4 of them ameliorated temporarily.


CONCLUSIONS
Direct lymphangiography, CT (immediately after direct lymphangiography) are the most important diagnosis methods. The influence of the therapy to the malformed lymphatic system of patients should be well considered. Lymph-vein shunting, such as thoracic duct-left external jugular vein anastomosis, gastroenteral or retroperitoneal lymphatics-testicular or ovarian vein anastomosis, could improve the circulation of lymph and chyle of patients. Lymphatic microsurgery will play more and more important roles in the treatment of chylous diseases.
Shen
Wen-bin
WB
Department of Lymphatic Surgery, Beijing Gongan Hospital, Beijing 100006, China. 80852swb@sina.com
Sun
Yu-guang
YG
Xia
Song
S
Wu
Guo-fu
GF
Geng
Wan-de
WD
Sun
Ying-xian
YX
Chang
Kun
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002915:Chylous Ascites / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D042601:Lymphatic Vessels / Q000601:surgery; D008220:Lymphography; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D014057:Tomography, X-Ray Computed