Disease Information for Surgical ligation/Cysterna lymphatics

What ever the cause chylous ascites presents with diarrhea and failure to thrive in kids; acquired or congenital; paracentesis and medium chain fat diet will occsionally give spontaneous cure in kids; Lymphectasia congenital defect with milder dysplasia in onset as adults presents as protein losing enteropathy; Hypogammaglobulinemia, hypoambuminemia, and lymphopenia occur; Ascitic fluid has lymphocytes but may not be milky if not postprandial; No real treatment in kids; Surgical venous drainage connection more successful in adults; Cause of acquired disease are blocks at central lymphatics, cysterna chyle, and thoracic duct; infections, inflammatory,neoplastic malignancy, and trauma with hematoma scar retroperitoneal sepsis; may be complication of hemorrhagic necrotizing pancreatitis; If thoracic duct involved pleural chylous effusion predates the ascites; Often the fluid wave, shifting dullness, and distended abdonmen are present; Retroperitoneal edema shows on imaging; One or both lower extremities are edematous; Often this is fatal if untreated, especially with kids; Complicating infection occurs; Some causes in adults are tuberculosis, schistosomiasis, retroperitoneal hematoma, carcinoma retroperitoneal, section at surgery, transection with gunshot etc; Usually not discovered and idiopatic acquired----Pediatric current DXRX Hay Sondheimer 14th 1999]--------------------------------

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