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Authors presented the first 3 described in Polish literature patients with primary chylopericardium. 2 of them underwent surgery. Literature review was performed based on presented till now 44 cases with this rare disease. Causes, diagnostics and therapy methods of chylopericardium were discussed especially emphasizing significance of the operation based on pericardium fenestration and supradiaphragmatic thoracic duct ligation.
On the case of 10 years old boy with chyluria the authors emphasize the importance of lymphographic examination for proving the pyelolymphatic connection. The lymphographic examination was applied after the complete examination including computer tomography and ultrasound, since these examinations did not prove changes of the urinary and lymphatic systems which could explain the milky clouding of the urine lasting for several months. Changes in the biochemical profile were significant as well as non-constant ejaculation of milky cloudy urine from the opening of the right ureter. The lymphographic examination proved the link between the lymphatic urinary systems with changes on the lymphatic vessels and nodes.
The functional state of the gastric mucosa in dogs after 12.7 Gy abdominal X-ray irradiation was examined. During the first 7 days after irradiation, hypochylia, decrease of proteolytic activity and the H+ (hydrogen-ion) production in the gastric juice was observed. The gastric mucosal cells of rats were examined after the irradiation with 12 Gy to find out the reason for hypochylia. Possibly the reduction of the number of the gastric mucosal cells and their protein content one day after the irradiation, as well as functional disorders of the outer membrane--expressed by the decrease of the intracellular K+ (potassium-ion) level and the ATPase and 5'-nucleotidase activity--may be the reasons for the hypochylia after irradiation.
A Dutch woman with non-parasitic chyluria is described. Lymphangiography and abdominal CT demonstrated retroperitoneal lymphangiectasis, dilated and tortuous lymphatic ducts around the right pyelocaliceal system and contrast in the bladder. The thoracic duct was patient. There were no metabolic or immunological abnormalities. The aetiology was probably congenital malformation of the lymphatic system. The treatment was conservative.
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A case of segmental renal arterial thrombosis occurring after bilateral surgical stripping and interruption of renal pedicle lymphatics for chyluria is presented. This case showed elevation of serum creatinine (6.6 mg/dl) and lactate dehydrogenase (1131 IU/L) on the 4th day after operation, and on the 14th day, renal scintigraphy with 99 m-Tc diethylenetriamine penta acid acetic showed bilateral marked decrease of glomerular filtration rate. Aortography and selective left renal angiography demonstrated left segmental renal thrombosis, but right renal arteries were intact on the 20th day after operation. Systemic anticoagulation therapy was performed, but left renal function was destroyed completely. Excessive and prolonged retraction of the renal artery with vascular tape may have resulted in this unfortunate complication.
The wall of the rabbit small intestine was found to take part in regulation of the balance of general lipids, fatty and bile acids of arterio-venous blood both in intact animals and in those with hypercholesterolemia. Excessive amount of cholesterol in food reconstructs the lipid composition of enterocytes which loose important bile and fatty acids, accumulating nonequivalent intermediary products of lipid metabolism which affects the membrane permeability, readjusts the lipid exchange in enterocytes and their control over lipid complexes circulating in the blood.
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A 43-year-old woman complaining of upper abdominal pain was referred to our clinic. Well movable mass was detected in the right hypochondria region by palpation. Three years before, she underwent cholecystectomy and choledochotomy for cholelithiasis. After that she had been aware of painless mass in the right hypochondria region, but because of no symptom she regarded it as operative scar and had no treatment. Abdominal CT, ultrasonography, upper GI series and barium enema revealed a retroperitoneal cyst compressing the 3rd portion of the duodenum upward and the vena cava backward. Laparotomy showed an unilocular chylous cyst, 5 cm in diameter in the retroperitoneal cavity. Histologically, the cyst was cystic lymphangioma. Etiologically, the previous operation of cholecystocholedocholithiasis was supposed to be a trigger of the development of the chylous cyst.
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