A lymphographic study of chyluria

Ninety patients with chyluria were studied by bilateral pedal lymphography. The retroperitoneal lymphatic vessels were dilated, tortuous and increased in number in 61% of cases while the appearance of the lymph nodes was abnormal in 67% of cases. Renal lymphatic reflux, either bilateral or unilateral, was seen in 93% of patients. A correlation (P greater than 0.007) was observed between the site of origin of the cisterna chyli and side of unilateral renal lymphatic reflux. There was no evidence of thoracic duct obstruction although the thoracic duct was more than 3 mm in calibre in seven cases. Lymphography was also performed on 22 patients who had undergone stripping of the lymphatics along the renal pedicle to determine if surgical disconnection was complete. The pathogenesis of chyluria is briefly discussed.