Multiple causes include abdominal surgery ,blunt abdominal trauma.
Chylous ascites is a milky-appearing peritoneal fluid that is rich in triglycerides. It is due to the presence of thoracic or intestinal lymph in the abdominal cavity. It can be the result of congenital defects of the lymphatic system, inflammatory processes, malignancy, and trauma surgical or otherwise. The development of chylous ascites following retroperitoneal surgery is a rare but potentially devastating complication with significant morbidity .Chylous ascites is a rare clinical condition that occurs as a result of disruption of the abdominal lymphatics.
Other symptoms are cancerous neoplasms-hepatoma, tiny intestine lymphoma, tiny intestine angiosarcoma, and retroperitoneal lymphoma ,unscripted bacterial peritonitis , peritoneal dialysis ,abdominal tuberculosis ,carcinoid syndrome and inborn defects of lacteal establishment. In adults, chylous ascites is associated almost often with cancerous conditions. These conditions especially include lymphomas and disseminated carcinomas from primaries in the pancreas, bosom, colon, prostate, ovary, testes, and kidney. Inflammatory disorders, such as tuberculosis, can infrequently be associated with chylous ascites.
In children, the most common causes are congenital abnormalities, such as lymphangiectasia, mesenteric cyst, and idiopathic "leaky lymphatics. Chylous ascites may result from neoplasm, inflammation, or traumatic rupture of the intestinal lymphatics or lacteals. Although chylous ascites is rarely a malignant disease, the clinical course is often unrelenting and may be fatal, particularly in infancy. "Treatment of the chylous ascites is divided into four areas first is exploratory laparotomy with either direct ligation or drainage. Second is median chain triglyceride diet (MCT diet). Third NPO and hyperalimentation; and last venoperitoneal shunting.
A low-fat diet with medium-chain triglyceride supplementation can cut the flowing of chyle into the lymphatics. Typically, medium-chain triglyceride oil is administered orally at a dosage of 15 mL 3 times per day at meals. Postsurgical chylous ascites normally resolves with positive therapy. Early reoperation is indicated when the place of leak is obvious and if the patient is a better operational nominee. Use of TIPS to successfully handle chylous ascites related to cirrhosis has been reported.
