Experimental Studies on Lymphatic Blockage

Blalock, Alfred

doi:10.1001/archsurg.1937.01190120075005

Cited by 131 publications

(46 citation statements)

References 8 publications

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“…Chyloperitoneum after surgery may be easier to prevent than to cure. In 1937, Blalock and colleagues [11] found that ligation of all major identifiable lymphatic trunks in both cats and dogs rarely resulted in chylous ascites. With careful attention to the lymphatic network, this complication can be avoided.…”

Section: Discussionmentioning

confidence: 99%

A rare complication of D3 dissection for gastric carcinoma: chyloperitoneum

et al. 2005

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Section: Discussionmentioning

confidence: 99%

A rare complication of D3 dissection for gastric carcinoma: chyloperitoneum

et al. 2005

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“…10) It has been shown in animal studies that, in the presence of normal venous pressure, even when the thoracic duct is ligated, the development of chylous ascites is prevented by collaterals between the lymphatic and systemic circulations. 11,12) In cases where the lymphatic circulation is blocked, collaterals between the thoracic duct and the azygous vein or the inferior vena cava provide decompression of the lymphatic system. However, effective collateral circulation does not develop when the venous pressure is increased.…”

Section: A B Discussionmentioning

confidence: 99%

Chylous Ascites and Pleural Effusion Secondary to Constrictive Pericarditis Presenting With Signs of Lymphatic Obstruction

et al. 2004

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SUMMARYChylous ascites is a clinical entity characterized by accumulation of milky fluid containing high amounts of triglycerides in the peritoneal cavity. The cause is usually lymphatic obstruction secondary to neoplastic processes. Constrictive pericarditis rarely causes cylous ascites through elevated venous pressure and lymphatic stasis. To the best of our knowledge, there is no report of constrictive pericarditis leading to chylous ascites in a patient presenting with objective lymphangiographic findings of lymphatic obstruction rather than stasis. We present a case of chylous ascites and pleural effusion secondary to constrictive pericarditis presenting with signs of lymphatic obstruction in lymphangiography, in whom complete clinical and laboratory improvement was achieved after pericardiectomy. (Jpn Heart J 2004; 45: 535-540)

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“…Ligation of both the major lymphatics and lymphaticovenous anastomoses were necessary to cause chylous collections. 20 Although not proven in humans, it is possible that individuals with a paucity of these collaterals may be prone to chylous ascites. 12 In post-OLT chylous ascites, lymphatic damage at the porta hepatis and retroperitoneum are believed to be responsible.…”

Section: δmentioning

confidence: 99%

Chylous Ascites After Liver Transplant: Case Report and Review of Literature

Mukerji

Tseng

Karachristos

et al. 2013

Exp Clin Transplant

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Case: A 62-year-old man with cirrhosis, hepatitis C, and hepatocellular carcinoma, underwent a liver transplant. On day 11 after surgery, a chylous leak from a partial wound dehiscence was noted. The leak did not respond to 2 weeks of uninterrupted, fat-free clear liquid diet and 12-hour total parenteral nutrition at night. The same treatment was continued for another 6 weeks with fatty meal challenge every weekend, which he failed. He was then given a fat-free clear liquid diet, 24-hour total parenteral nutrition, and octreotide 100 μg subcutaneously every 8 hours for 14 days. A prompt response was noted. His recovery was excellent at the time of this writing (9 months' follow-up). Discussion: Eleven major cases have been reported with 9 cases being managed conservatively. Four were given a diet plus total parenteral nutrition without octreotide producing a cure in 3 to 36 days. Two cases (including ours) were given the diet and total parenteral nutrition, which failed; octreotide was then added, and these cases were cured in 2 to 4 weeks. Therefore, diet with total parenteral nutrition failed in 33.3% of the cases (2/6). In 3 cases, octreotide was used from the outset. They were all cured in ≤ 2 weeks. One case was operated on for peritonitis; chylous ascites was found and a leak was ligated. One patient with congenital lymphatic disorder underwent peritoneovenous shunting. Octreotide was not used in any of the cases of chylous ascites that were treated surgically. Conclusions:If exploratory surgery is done for any other reason, it is best to identify a chylous leak and ligate it. Otherwise, we recommend octreotide combined with a fat-free, clear liquid diet, and supplementation with medium chain triglycerides and total parenteral nutrition from the outset.

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Experimental Studies on Lymphatic Blockage

Cited by 131 publications

References 8 publications

A rare complication of D3 dissection for gastric carcinoma: chyloperitoneum

A rare complication of D3 dissection for gastric carcinoma: chyloperitoneum

Chylous Ascites and Pleural Effusion Secondary to Constrictive Pericarditis Presenting With Signs of Lymphatic Obstruction

Chylous Ascites After Liver Transplant: Case Report and Review of Literature

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