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June 1970

Chylous AscitesNewer Insights and Many Remaining Enigmas

Arch Intern Med. 1970;125(6):1073-1077. doi:10.1001/archinte.1970.00310060151022

When a condition appears rarely and sporadically, few clinicians have the opportunity to collect adequate information and to develop interest and expertise. Such is the case with chylous ascites and, as a result, many aspects of this phenomenon remain poorly understood. The pathophysiology has not been clearly defined, the underlying disease often proves elusive with present diagnostic procedures, and effective therapy is frequently not possible. The incidence has not been satisfactorily established; at Charity Hospital of Louisiana, New Orleans, there was approximately one patient per 100,000 admissions from 1936 to 1956.1 The actual occurrence of chylous ascites is probably higher, as the condition is usually unsuspected; the patient may die or the process resolve without the presence of the condition being revealed by paracentesis. In addition, the incidence is probably not constant, and is likely to vary as etiological factors vary with geographical area (eg, filariasis) or with the

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