Management of Chylous Extravasation

Abstract

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 Morton^7,93 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