[The causes of chylous ascites: a report of 22 cases].

OBJECTIVE: To review the causes and test the diagnostic accuracy of chylous ascites in 22 cases hospitalized in recent years and to compare the efficacy of current investigative procedures with those of previous decades. METHODS: 22 patients with chylous ascites were studied; they were admitted into Peking Union Medical College Hospital in 7 years (1990 - 1997). The data of the 22 patients were compared with those of 17 cases in previous 67 years (1923 - 1989) in the same hospital. Twelve of 22 patients underwent (99)Tc-labeled lymphoscintigraphy. RESULTS: Chylous ascites was diagnosed by ascites in all the 22 patients with analysis of ascitic fluid. Otherwise, the diagnosis would not be established in eight cases if examined with the naked eye. The causes of all the 22 cases were clearly diagnosed. However, the causes were not known in five cases in the 17 cases of previous years. The main causes in this group were malignant tumors (6/22), hepatic cirrhosis (5/22) and tuberculosis (4/22). Other causes included traumatic and congenital lymphatic lesions. CONCLUSION: The causes of chylous ascites can be made clear and definite by detailed comprehensive examinations, including scintigraphy. The main causes were malignant tumor, hepatic cirrhosis and tuberculosis.