Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Chyle”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed2000

Octreotide in the treatment of thoracic duct injuries.

Anecdotal reports support the use of octreotide in the treatment of traumatic thoracic duct injuries and chylothorax, but no prospective studies have proved its efficacy. We evaluated the effects of octreotide in treating thoracic duct transection in a canine model. Eight mongrel dogs (27.8+/-5.1 kg) were fed one pint of 10.5 per cent milkfat 2 hours before operation. Through a left supraclavicular neck incision, the thoracic duct was identified and transected, producing free flow of chyle. A quarter-inch drain was tunneled subcutaneously from the wound and attached to closed suction. After wound closure dogs were randomized to a control group (n = 4) receiving sham injections of saline subcutaneously three times per day, or a treatment group (n = 4) given 3 microg/kg octreotide three times per day. Postoperatively all dogs were fed a standard low-fat (5-7%) crude fat diet. Drain output was measured each day, and on odd-numbered postoperative days the drainage was analyzed for cholesterol, triglycerides, albumin, and total protein. Fistula closure was defined as drainage <10 ml/24-hour period. Treated dogs achieved fistula closure significantly faster than controls: 3.5+/-1.3 days versus 7.8+/-1.0 days (P = 0.0037). Whereas equivalent amounts of drainage occurred on the day of surgery and on postoperative day one in both groups, by postoperative day 2 the treatment group had significantly less drainage over 24 hours: 63+/-69 ml versus 195+/-79 ml (P = 0.046); this significant difference persisted through postoperative day 5 when drainage began to decrease in the control group. No significant differences between groups were seen in levels of cholesterol, triglycerides, albumin, or protein in the drainage at any time point. We conclude that octreotide is effective in treating thoracic duct injury, leading to an early decrease in drainage and early fistula closure. The mechanism for this effect remains to be clarified.

Animals↗
PubMed1998

[Prevention and management of chylous fistula after neck dissection].

OBJECTIVE: To evaluate the effect of treatment for chylous fistulas after neck dissection, as a means of reasonable option of therapeutic measures. METHODS: Of 37 chylous fistulas, 30 were left-sided and 7 were right-sided. Conservative therapy which included closed-wound drainage and local pressure dressing and/or low-fat nutritional support was employed in 26 cases, and 50% glucose was injected into the neck basic wound bed in 2 cases, to promoto the chylous fistula healing up. Operative ligation was performed in 7 cases. Open-wound and packing in 4 cases. RESULTS: Eighty-six percent chylous fistula occured from 1 to 3 postoperative days. Of 26 chylous fistulas with conservative management, 15 cases were successfully treated, the mean duration for healing was 9.7 (4-30) days, the remaining 11 cases failed to had and were further treated surgically. Seven cases with operative ligation were successful, and the other 4 cases with open-wound and packing had delayed healing, the mean duration was 8.5 (7-10) days. CONCLUSION: The majority of patients with chylous fistulas could be treated reasonablly without increasing the hospital days. The conservative therapy should be employed in cases with a maximal production of chyle below 500 ml a day. Operative ligation should be done early in cases with a maximal production exceeding 500 ml a day and with conservative treatment failure for a few days. The open-wound and packing should be used in chylous fistulas persisting for more then 7 days.

Adolescent↗
PubMed2002

Retroperitoneoscopic lymphatic management of intractable chyluria.

PURPOSE: We present our experience with retroperitoneoscopic lymphatic disconnection for the treatment of patients with intractable chyluria and review the current literature. MATERIALS AND METHODS: Our study included 6 males and 3 females 22 to 55 years old who presented with intractable chyluria of filarial origin and variable duration (2 to 11 years), and were selected for retroperitoneoscopic management of 11 renoureteral units. Diagnosis was based on urine examination for the presence of chyle and fat globules, cystoscopy, excretory urogram and retrograde ureteropyelography. The technique of retroperitoneoscopic management of chyluria consisted of nephrolympholysis, ureterolympholysis, hilar vessel stripping, fasciectomy and nephropexy. The first 3 procedures were done in all cases, whereas fasciectomy was only done in 4 cases and nephropexy in 3 as required. RESULTS: Chyluria disappeared in all ipsilateral renal units of the patients who underwent retroperitoneoscopic management but it recurred in 2 patients at 1 and 9 months of followup from the contralateral side. Both cases have since been successfully treated with contralateral retroperitoneoscopic management. Complications included lymphatic leak through the drain which persisted for 5 days in 1 case and an inadvertent clipping of a branch of the posterior segmental artery of the kidney in 1. The latter patient did not have pain or hypertension and the renal scan did not reveal any focal deficit at followup. All patients were followed periodically from 6 months to 41/2 years (mean of 31 months). CONCLUSIONS: The objectives of open surgical treatment of intractable chyluria can be achieved by the minimally invasive retroperitoneoscopic technique. Nephrolympholysis, ureterolympholysis and stripping of hilar vessels were essential in all cases. Fasciectomy and nephrectomy were done in a few patients and as mentioned are not recommended routinely. This approach has all of the benefits of laparoscopic surgery without compromising the principles of open surgery. Retroperitoneoscopic management was safe, effective and efficient.

Adult↗
PubMed2002

Treating external chylous fistula with retroperitoneal lymphangiectomy plus lymph-vein shunting.

OBJECTIVE: To discuss the diagnosis and therapy of chylous reflux and external chylous fistula. METHODS: All of 6 patients were diagnosed with direct lymphagiography, lymphscintigraphy. Among them, 2 patients received CT after direct lymphagiography. Retroperitoneal lymphangiectomy plus lymph-vein shunting was performed in 5 patients, and retroperitoneal lymphangiectomy in 1 patient. RESULTS: The 6 patients were followed up from 6 months to 6 years. In 5 patients, chylous cysts disappeared and chylous fistula closed, and in 1 patient, chylous fistula didn't cicatrize, and chyle still leak out from the scrotum. CONCLUSIONS: Retroperitoneal lymphangiectomy plus lymph-vein shunting has curative effect on chylous external fistula of the lower extremity and genitalia, but it has the chance to not obstruct all paths of chylous reflex.

Chyle↗
PubMed2002

[Chyluria].

Chyluria is the passage of chyle into the urine giving it a typical milky appearance, it's due to a communication between lymphatic and urinary system. Filariasis is the most frequent cause of chyluria. Considering the infrequency of chyluria in our environment, a literature review is made, explaining the most frequent etiological data, as well as clinical signs, diagnostic means, conservative and surgical procedures in the treatment of this process.

Chyle↗
PubMed1959

The management of chylothorax.

Chylothorax is readily diagnosed from the characteristic qualities of the effusion. Treatment should initially be conservative, consisting of multiple aspirations followed, if necessary, by suction drainage. Approximately half of the patients will not respond to these measures, and direct ligation and division of the duct is necessary for cure. This operation is most readily carried out through the right chest, the thoracic duct being ligated just above the diaphragm. In cases in which the duct is surrounded by tumor, radiotherapy to the mediastinum is often successful in controlling the reaccumulation of chyle, but irradiation is generally not recommended until after a tissue diagnosis has been made by thoracotomy. Nutritional problems are often concomitants of chylothorax.

Chyle↗
PubMed2003

Retroperitoneoscopic renal pedicle lymphatic disconnection for chyluria.

OBJECTIVE: To report our experiences in retroperitoneoscopic renal pedicle lymphatic stripping for chyluria. METHODS: Six cases of filarial chyluria were admitted to our hospital from November 2001 to June 2002. Of these cases, 4 were men and 2 women, with age ranging from 34 to 52 years (mean, 42 years). Diagnosis was made by using urine test for the presence of chyle and fat globule, cystoscopy, excretory urogram and retrograde pyelography. Chyluria was found on the left renal unit in 2 cases and on the right side in 4 cases. The technique of retroperitoneoscopic management of chyluria consisted of nephrolympholysis, hilar vessel stripping and ureterolympholysis. RESULTS: Operative time ranged from 69 to 120 minutes (mean, 95 minutes). Intraoperative blood loss was 50-180 ml (mean, 85 ml). Chyluria disappeared in all patients immediately after operation. Mild hematuria occurred in 4 cases within 12 hours and disappeared at 24 hours. Subcutaneous emphysema around the lesions was found in 2 cases and was spontaneously absorbed 3 days after the treatment. There was no lymphatic leak at the lesions. The patients were discharged from the hospital 5-9 days after the treatment. All patients gained weight and their haemoglobin and serum protein increased by 13.5 g/L and 3.66 g/L respectively. No chyluria recurrence was reported during 1-1.6 years follow-up. CONCLUSIONS: Retroperitoneoscopic renal pedicle lymphatic disconnection for chyluria is a safe, effective and efficient surgical procedure with minimal invasion, less pain, lower morbidity, short hospital stay and rapid recovery.

Adult↗
PubMed1990

Combined chylothorax, chylopericardium, and cranial vena cava syndrome in a dog with thymoma.

A dog was examined because of anorexia and development of submandibular, sternal, and forelimb edema. Physical examination revealed engorged jugular veins and engorged blood vessels of the conjunctivae and nictitating membranes. Thoracic radiography revealed pleural and pericardial effusions, later identified as chyle. Contrast angiography revealed an intravascular mass, later identified as thymoma, in the cranial vena cava.

Animals↗
PubMed1979

Cutaneous chylous reflux. The weeping scrotum.

The cutaneous lesions associated with reflux of lymphatic fluid and chyle from the skin have received little attention in the dermatologic literature. We describe a patient with such lesions, and discuss the clinical, histopathologic, and lymphangiographic manifestations. We review the classification of lymphedema and the commonly seen cutaneous lesions.

Adolescent↗
PubMed1994

Chylothorax.

The management of chylothorax requires a thorough understanding of the anatomy and pathophysiology of the major thoracic lymphatics, prompt diagnosis, and (with rare exception) conservative management, including evacuation of the pleural space, nutritional support, and measures to reduce chyle production. A minority of chylothoraces will fail to resolve with these measures. Surgical intervention is then required to prevent chronic metabolic deterioration and death.

Chyle↗
PubMed1993

Primary chylopericardium: report of a case.

A 14-year-old girl was admitted due to exertional dyspnea of one month's duration. A grade 3/6 holosystolic murmur with distant heart sounds was heard at the left sternal border. Chest roentgenograms and echocardiograms showed a large amount of pericardial and left pleural effusion and a small perimembranous ventricular septal defect. Subxyphoid pericardial drainage and left pleural intubation were performed. The fluid from both sites was defined as chyle by the milky white appearance, presence of microscopic fat droplets and the lymphocyte predominance in the white cell count. Lymphangiograms and a chest computed tomographic scan demonstrated thoracic duct obstruction and leakage of contrast to pericardial and pleural spaces. The patient was treated with a medium chain triglyceride diet. Unfortunately, massive reaccumulation of the effusion was later noted. Therefore, a median sternotomy with ligation of the thoracic duct, creation of a posterior pericardio-pleural window and implantation of a left pleuro-peritoneal shunt with a Denver peritoneo-venous shunt were performed. Follow-up for one year with two-dimensional echocardiograms showed no more accumulation of the pericardial effusion.

Adolescent↗
PubMed1994

Stomatherapy management of chylous drainage.

Injuries to the thoracic duct resolve over a period of up to three weeks. Reabsorption of chyle occurs spontaneously into the venous system via the left subclavian vein. Should this have been damaged, a collateral system will be established. If the drainage persists in spite of strict conservative management including total parenteral nutrition, exploration of the duct is recommended.

Adult↗
PubMed1993

[Primary chylopericardium: a case report].

A case of primary chylopericardium in a 54 year-old-man was reported. Despite 3 times of pericardiocentesis, the pericardial fluid accumulated rapidly. After the fenestration of pericardium, a small cannula was inserted for the thoracic ductgram which showed a clearly visible duct upward to the angulus venosus and an abnormal branch near the bifurcation of the trachea spilling some contrast material into the pericardial cavity. Ligation and division of the thoracic duct including an abnormal branch was performed from its entry to the thorax for a length of 13 cm upward. The postoperative course was uneventful and chest X-ray film taken 6 months after surgery showed no accumulation of chyle in the pericardium and pleural cavity.

Chyle↗
PubMedDate not supplied

Congenital chylothorax.

Congenital chylothorax is a rare condition in which chyle accumulates in the pleural space because of an intrauterine obstruction or anomalies of the thoracic duct. This paper presents a case of congenital chylothorax diagnosed antepartum echographically. The patient's history revealed a previous sibling with a similar diagnosis. The baby developed respiratory distress after delivery and the diagnosis was established by thoracentesis. Computed tomography of the chest and nuclear lymphangiography were obtained to evaluate the origin of the pleural effusion, but a congenital fistula or other pathology of the thoracic duct could not be demonstrated. Management of the baby consisted of ventilatory support in the delivery room, repeated thoracentesis and thoracostomy tube drainage, total parenteral nutrition and formula containing medium-chain triglycerides. The infant was discharged six weeks after birth in good condition.

Adult↗
PubMedDate not supplied

The oral manifestations of intestinal lymphangiectasia: case report.

Intestinal lymphangiectasia is a rare autosomal dominant disorder or acquired condition that leads to lymph obstruction, poor chyle transport, and concomitant problems of hypoproteinemia, lymphocytopenia, hypogammaglobulinemia, and peripheral edema. Patients develop diarrhea, steatorrhea, and hypocalcemia secondary to fat-soluble vitamin malabsorption. Treatment is a restrictive diet of low fat, medium chain triglycerides. Oral manifestations are gingivitis due to poor PMN function and enamel defects due to poor calcium absorption. A case of a 14-year-old boy with both gingival and enamel problems secondary to intestinal lymphangiectasia is reported.

Adolescent↗
PubMed1998

Chylous reflux into the lower limb with septic shock successfully treated by resection of the retroperitoneal megalymphatics.

A 15-year-old boy with primary chylous reflux into the left lower limb with septic shock was successfully treated by en bloc resection and ligation of the retroperitoneal megalymphatics. The episode of chyle discharge from the lower limb and/or genitalia and the presence of small vesicles of the skin may be an important sign in diagnosing chylous reflux. Surgical interruption of the chylous reflux and reduction of girth may be needed.

Adolescent↗