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The Surgical Significance of Chylous Ascites

John S. Vasko, MD; Richard I. Tapper, MD
Arch Surg. 1967;95(3):355-368. doi:10.1001/archsurg.1967.01330150031006.
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CHYLOUS ascites, although rare, has been recognized as a clinical problem since the 17th century1-4 and its uncommon occurrence is reflected by the infrequent publications which consist largely of single case reports. The frequency with which chylous ascites occurs is difficult to ascertain but it is noteworthy that only nine cases were recognized among 1,688,760 general admissions to the Charity Hospital in New Orleans between 1936 and 1956.5 A study from the University of Utah hospitals reported an incidence of one case in 56,343 admissions.6

The striking appearance and relative rarity of chylous peritoneal effusions has provoked considerable interest among clinicians but surprisingly little meaningful information is available regarding its etiology, diagnosis, and treatment. There is uniform agreement that chylous ascites is not by itself a pathologic entity but rather a fascinating sequelae of an internal lymph fistula of obstructive or traumatic origin. The known etiologic factors


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