Atraumatic chylous ascites may be caused by a large number of conditions. It may present with a number of clinical signs and symptoms.


Clinical findings:

(1) abdominal distention due to fluid accumulation

(2) peritonism (abdominal pain, tenderness, variable constipation or diarrhea, variable vomiting, absence of peritoneal inflammation seen with peritonitis)

(3) other forms of abdominal pain

(4) dysphagia

(5) progressive peripheral edema



• Abdominal distention is a common finding but may be absent in mycobacterial infections or with pancreatitis.


Chylous ascites can be identified as an incidental finding in an asymptomatic patient or a patient with findings ascribed to another cause.


Laboratory testing of chylous fluid:

(1) fluid triglyceride concentration

(2) white blood cell count and differential

(3) cytology

(4) bacterial and mycobacterial culture

(5) amylase and lipase on fluid and serum if pancreatitis suspected

(6) serum liver function tests


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