A. Bellabah et al., CHYLOUS ASCITIS IN PATIENTS WITH HEPATIC CIRRHOSIS - A REVIEW OF 3 CASES, La Semaine des hopitaux de Paris, 74(33-34), 1998, pp. 1269-1272
Chylous ascites in cirrhosis of the liver is a rare event whose freque
ncy and pathophysiology remain unknown. Three cases seen over a 20-yea
r period are reviewed. Spontaneous chylous ascites was-the presenting
symptom in all three cases. The diagnosis was based on the lactescent
appearance of the ascites fluid with a total lipid content above 3 g/L
including 50% triglycerides. Laboratory tests, imaging studies, and e
ndoscopy evaluations established the diagnosis of cirrhosis. Managemen
t consisted in a low-salt diet with supplemental medium-chain triglyce
rides, repeated aspiration of the ascites fluid, albumin infusions, an
d diuretic therapy. The outcome was considered favorable. Based on a r
eview of the literature, the diagnostic pitfalls, therapeutic options,
and prognosis of chylous ascites complicating cirrhosis of the liver
are reviewed.