CHYLOUS ASCITIS IN PATIENTS WITH HEPATIC CIRRHOSIS - A REVIEW OF 3 CASES

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.