Few clinicians have the opportunity in a lifetime of practice to observe a case of massive chyloperitoneal effusion. This is evidenced by the multiplicity of single case reports, with few exceptions.2,12,41-43 Chylous ascites is a manifestation and not a disease entity; it represents an "obstructive phenomenon." Although the etiology is unknown, there is usually some distinct pathologic condition appearing simultaneously in the patient to account for the effusion. An abnormal accumulation of chyle occurs in the pleural, pericardial, and peritoneal cavities and is seldom diagnosed preoperatively in the last two sites. The purpose of this paper is to review some of the data pertaining to the lymphatic system and to report three cases of chylous ascites recently encountered.
Since Aselli discovered the lymphatic system in 1622, considerable information has been brought forth relative to the properties and function of lymph. Bartholin, in 1651, described the first case of chylothorax.