June 1959

Management of Chylous Extravasation

Author Affiliations

Salt Lake City
Department of Surgery, University of Utah College of Medicine.

AMA Arch Surg. 1959;78(6):815-831. doi:10.1001/archsurg.1959.04320060003001

The extravasation of chyle into thoracic and abdominal cavities has been recognized as a clinical problem since the 17th century. Shortly after publication of the clinical studies of Asellius,4 reports of traumatic chylothorax were mentioned by Bartolet109 in 1633, by Longelot6 in 1663, and by de Diemerbroeck44 in 1685, and a detailed description of the condition was given by Quincke132 in 1875. In 1691 Morton7,93 described chylous ascites in a boy of 2 years, who eventually died following withdrawal of fluid from the abdominal cavity. Following clinical observations on obstruction of the thoracic duct, Sir Astley Cooper31 performed experiments on the effects of ligation and reported his findings in 1798.

A number of reviews with collected cases have appeared. Busey24 recorded 53 cases of chylous ascites and reported them in 1889. Wallis and Schölberg163 collected 173 cases of "milky ascites," 3

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