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J Vet Cardiol 2022 May 18;42:47-51. Epub 2022 May 18.

AniCura Specialistisch Verwijscentrum Haaglanden, Frijdastraat 20a, Rijswijk, 2288 EZ, the Netherlands; Veterinaire Specialisten Vught, Reutsedijk 8a, Vught, 5264 PC, the Netherlands.

A 2-year-old 33 kg female castrated Labrador Retriever was referred for exercise intolerance, hyporexia, and abdominal distention. Point-of-care ultrasound revealed ascites, hepatic congestion, severe pericardial effusion, and cardiac tamponade. Pericardiocentesis was performed, and the chylous nature of the fluid was confirmed by cytology, triglyceride, and cholesterol measurements. Read More

J Minim Access Surg 2022 Jul-Sep;18(3):469-471

Department of Pediatrics, Santokba Durlabhji Memorial Hospital and Research Institute, Jaipur, Rajasthan, India.

Chylous ascites (CA) is a form of ascites having leakage of lipid-rich lymph into the peritoneal cavity, due to damage or obstruction in the lymphatic system. Aetiology of CA could be congenital or acquired. Primary lymphatic hypoplasia is seen commonly in children and presents with lymphoedema, chylothorax or CA. Read More

Cureus 2022 May 9;14(5):e24861. Epub 2022 May 9.

Department of Hematology and Oncology, Cleveland Clinic, Cleveland, USA.

Amyloidosis is caused by the extracellular deposition of fibrils composed of low molecular weight protein subunits. Its two main types are amyloid light chain (AL) amyloidosis and amyloid A (AA) amyloidosis (previously referred to as secondary amyloidosis). Clinical manifestations are dependent upon location, type, and amount of deposit. Read More

J Lipid Res 2022 Jun 3:100237. Epub 2022 Jun 3.

Nutrition, Metabolism and Genomics Group, Division of Human Nutrition and Health, Wageningen University, the Netherlands. Electronic address:

Angiopoietin-like 4 (ANGPTL4) is an important regulator of plasma triglyceride levels and an attractive pharmacological target for lowering plasma lipids and reducing cardiovascular risk. Here we aimed to study the efficacy and safety of silencing ANGPTL4 in the livers of mice using hepatocyte-targeting GalNAc-conjugated antisense oligonucleotides (ASO). Compared to injections with negative control ASO, four injections of two different doses of ANGPTL4 ASO over two weeks markedly downregulated ANGPTL4 levels in liver and adipose tissue, which was associated with significantly higher adipose lipoprotein lipase activity and lower plasma triglycerides in fed and fasted mice, as well as lower plasma glucose levels in fed mice. Read More

Curr Oncol Rep 2022 May 31. Epub 2022 May 31.

Department of Radiology, Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.

Purpose Of Review: The incidence of lymphatic leakage (iatrogenic and non-iatrogenic) is growing in cancer population due to the increased complexity of the surgical procedures and improved overall survival in cancer patients. The purpose of this article is to review the contemporary approach in the field of percutaneous lymphatic embolization in cancer patients with lymphatic leaks.

Recent Findings: Since the advent of intranodal lymphangiography in 2011 alongside with the MR and CT lymphangiography, the accuracy of diagnosis of the lymphatic diseases has significantly improved significantly. Read More

J Pediatr 2022 May 20. Epub 2022 May 20.

Vascular Anomalies Center, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, CO; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora, CO. Electronic address:

Objective: To evaluate the effect of RAS-MAPK pathway inhibitor Trametinib on medically refractory chylous effusions in three hospitalized patients with Noonan syndrome.

Study Design: Pharmacologic MEK1/2 inhibition has been used to treat conditions associated with Noonan syndrome given that activating RAS-MAPK pathway variants lead to downstream MEK activation. We describe our experience with three patients with Noonan syndrome (due to variants in three distinct genes) and refractory chylous effusions treated successfully with MEK inhibition. Read More

J Surg Case Rep 2022 May 17;2022(5):rjac150. Epub 2022 May 17.

Hospital Episcopal San Lucas, General Surgery, Ponce, Puerto Rico.

Post-surgical chylous ascites (CA) is extremely rare in colon surgery, known as the extravasation of creamy fluid rich in triglycerides accumulating in the peritoneal cavity. The incidence of CA after colorectal surgery remains between 1 and 6.5%. Read More

Langenbecks Arch Surg 2022 May 20. Epub 2022 May 20.

Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin Er Road, Shanghai, 200025, China.

Background: Chylous ascites (CA) after laparoscopic D3 lymphadenectomy for right colon cancer is not rare. However, the risk factors for CA have not been fully explored. Few studies have investigated the effect of CA on long-term prognosis. Read More

N Engl J Med 2022 05;386(19):1834-1844

From the Departments of Medicine (M.D., J.S.A.), Radiology (M.A.A.), and Pathology (M.J.F.), Massachusetts General Hospital, and the Departments of Medicine (M.D., J.S.A.), Radiology (M.A.A.), and Pathology (M.J.F.), Harvard Medical School - both in Boston.

BJU Int 2022 05;129(5):559-560

Royal Marsden Hospital, London, UK.

Surg Case Rep 2022 May 10;8(1):92. Epub 2022 May 10.

Department of Gastroenterological Surgery, Kochi Health Science Center, 2125-1 Ike, Kochi, 781-8555, Japan.

Background: Chylous ascites (CA) is a rare complication of gastrectomy for gastric cancer. While most cases of postoperative CA improve with medication or nutritional support, some are refractory to conservative treatment. A peritoneovenous shunt (PVS) may help patients who are poor candidates for surgery. Read More

BMC Surg 2022 May 6;22(1):158. Epub 2022 May 6.

Department of Neonatal Surgery, Xi'an Children's Hospital & The Affiliated Children Hospital of Xi'an Jiaotong University, No. 69, Xijuyuan Lane ,Lianhu District, Xi'an, Shaanxi, 710003, China.

Background: Carbon nanoparticle suspension (CNS) was applied to locate the lymphatic leakage in chylous ascites (CA). However, the flow speed and distance of the CNS were particularly decreased in the following two cases (patient 5 and 6). This study aimed to investigate and improve the flow speed and distance of the CNS via a rat model. Read More

Childs Nerv Syst 2022 May 5. Epub 2022 May 5.

Department of Neurosurgery, China Medical University Hospital, North District, No.2, Yude Road, Taichung City, 404472, Taiwan, Republic of China.

Purpose: This study aims to evaluate the infection rates and catheterization duration of applying antibiotic-impregnated external ventricular drain (EVD) for the treatment of post-hemorrhagic hydrocephalus (PHH) in low birth weight infants (LBWI).

Methods: This retrospective cohort study included 13 preterm LBWI with PHH. Data were collected from the patient's medical charts and included gender, gestational age, birth weight, intraventricular hemorrhage grade, ventriculostomy-associated infection (VAI), and the duration of catheterization. Read More

Nihon Shokakibyo Gakkai Zasshi 2022 ;119(4):377-384

Department of Gastroenterology, Sano Kousei General Hospital.

A 70-year-old woman who was diagnosed with liver cirrhosis as a result of primary biliary cholangitis and heart failure by myocardial infarction 1 month ago complained of dyspnea and was admitted to our hospital. Image inspections showed right massive pleural effusion, so we performed thoracentesis and drainage. Despite no history of trauma or malignancy, we obtained milky white-yellow pleural effusion by drainage and it turned out to be transudative chylothorax. Read More

J Surg Case Rep 2022 Apr 4;2022(4):rjac155. Epub 2022 Apr 4.

Department of Surgical Services, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Chylous ascites is a unique phenomenon defined in the literature by ascitic fluid with a triglyceride content >200 mg/dl. This rather rare entity can be associated with a number of different pathologies related to abnormalities within the lymphatic system. This case report serves to demonstrate an intestinal volvulus and resultant chylous ascites found on exploratory laparotomy in an otherwise healthy individual who participated in routine, extreme abdominal exercises. Read More

Br J Hosp Med (Lond) 2022 03 24;83(3):1-3. Epub 2022 Mar 24.

Department of Urology, Queen Alexandra Hospital, Portsmouth, UK.

BMJ Case Rep 2022 03 29;15(3). Epub 2022 Mar 29.

Neonatal Intensive Care Unit, University College Hospital, London, UK

Cureus 2022 Feb 24;14(2):e22560. Epub 2022 Feb 24.

Obstetric and Gynecology, Universidad Las Palmas de Gran Canaria, Las Palmas de GC, ESP.

Chylous ascites is caused by an accumulation of lymphatic fluid in the peritoneal cavity secondary to a rupture or obstruction of the abdominal lymphatic ducts. It has a milky appearance and is rich in triglycerides. The most frequent etiologies are neoplasms, liver cirrhosis, and ruptured lymphatic vessels after abdominal surgery. Read More

J Gen Intern Med 2022 Jun 8;37(8):2082-2085. Epub 2022 Mar 8.

Section of General Internal Medicine, Yale School of Medicine, West Haven, CT, USA.

Sci Transl Med 2022 03 2;14(634):eabm4869. Epub 2022 Mar 2.

Human Molecular Genetics, de Duve Institute, University of Louvain, 1200 Brussels, Belgium.

Central conducting lymphatic anomaly (CCLA), characterized by the dysfunction of core collecting lymphatic vessels including the thoracic duct and cisterna chyli, and presenting as chylothorax, pleural effusions, chylous ascites, and lymphedema, is a severe disorder often resulting in fetal or perinatal demise. Although pathogenic variants in RAS/mitogen activated protein kinase (MAPK) signaling pathway components have been documented in some patients with CCLA, the genetic etiology of the disorder remains uncharacterized in most cases. Here, we identified biallelic pathogenic variants in , encoding the MyoD family inhibitor domain containing protein, in seven individuals with CCLA from six independent families. Read More

J Urol 2022 07 25;208(1):53-61. Epub 2022 Feb 25.

Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida.

Purpose: Chylous ascites (CA) is an uncommon complication that occurs from traumatic disruption of lymphatic channels after retroperitoneal surgery. The purpose of this study was to generate an evidence-based management strategy for CA by reviewing the current literature and available treatment modalities.

Materials And Methods: A MEDLINE® literature review was performed for "chylous ascites. Read More

Chest 2022 Feb;161(2):590

J Chest Surg 2022 Feb;55(1):81-84

Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Esophagectomy and esophageal reconstruction are commonly chosen as surgical options for esophageal cancer. However, prolonged untreated chyle leakage is associated with a poor prognosis. We report the case of a patient with refractory chylous ascites. Read More

Obes Surg 2022 04 19;32(4):1352-1355. Epub 2022 Jan 19.

Department of General Surgery, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran.

J Investig Med High Impact Case Rep 2022 Jan-Dec;10:23247096211065631

Augusta University Health, GA, USA.

Chylous ascites may result from a variety of pathological conditions, most of them from nontraumatic causes, such as congenital defects of the lymphatic system, infections, liver cirrhosis, and malignancy. Rarely, chylous ascites occurs as an iatrogenic complication after left-sided laparoscopic donor nephrectomy (LDN). Injury to the cisterna chyli and its main lymphatic tributaries around the para-aortic region intraoperatively can cause the lymphatic fluid to accumulate. Read More

S D Med 2021 Dec;74(12):554-558

University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.

Extravasation of total parenteral nutrition (TPN) from a malpositioned umbilical venous catheter (UVC) is a rare cause of ascites in neonates. The gross appearance of the aspirated peritoneal fluid may mimic congenital chylous ascites, delaying an accurate diagnosis of the causative source. UVC malpositioning is associated with complications of various organs as related to the position of the UVC tip. Read More

BJU Int 2022 05 23;129(5):585-587. Epub 2022 Feb 23.

Department of Urology, M.D. Anderson Cancer Center, The University of Texas, Houston, TX, USA.

Chin Med J (Engl) 2021 Dec 23;135(2):164-171. Epub 2021 Dec 23.

Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian 350001, China.

Background: Postoperative chylous ascites is an infrequent condition after colorectal surgery and is easily treatable. However, its effect on the long-term oncological prognosis is not well established. This study aimed to investigate the short-term and long-term impact of chylous ascites treated with neoadjuvant therapy followed by rectal cancer surgery and to evaluate the incidence of chylous ascites after different surgical approaches. Read More

World J Gastrointest Surg 2021 Nov;13(11):1361-1371

Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China.

Background: Chylous ascites following right colectomy has a high incidence which is a critical challenge. At present, there are few studies on the factors affecting chylous ascites after right colectomy and especially after D3 Lymphadenectomy. A predictive model for chylous ascites has not yet been established. Read More

J Nucl Med Technol 2021 Dec 21. Epub 2021 Dec 21.

Medical University of South Carolina, United States.

Lu-DOTATATE has gained wide clinical acceptance for the treatment of advanced gastroenteropancreatic neuroendocrine tumors; however, little is known regarding its accumulation in ascites. As such, clinical staff performing paracenteses shortly after a treatment dose may be concerned about their potential radiation exposure, or the risk of contamination. In this report, therapeutic paracenteses were performed on a patient with metastatic intestinal carcinoid complicated by recurrent chylous ascites at various time intervals following a standard 7. Read More