ORIGINAL ARTICLE   

Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2021 May;180(5):209-13

DOI: 10.23736/S0393-3660.20.04456-3

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Chylous ascites: a 5-year retrospective study

Nuno MELO ✉, Diana OLIVEIRA, Filipa GOMES, Jorge ALMEIDA

Department of Internal Medicine, São João University Hospital, Porto, Portugal

BACKGROUND: Chylous ascites is defined as a triglyceride concentration in the peritoneal fluid above 200 mg/mL. The only report about its epidemiology is from 1982 and it reported an incidence of 1/20,000 hospital admissions. It is thought that its incidence may be increasing due to increased incidence of several potential causes. The aim of this study is to estimate chylous ascites incidence and to identify the main causes of chylous ascites and mortality.
METHODSː This is a retrospective cohort study conducted in a general, tertiary care and teaching hospital. All triglyceride dosing done in ascitic fluid from January 2012 to June 2017 were evaluated and all adult patients with triglycerides >200 mg/dL were included. All data was collected from the hospital electronic database.
RESULTS: A total of 42 patients were included. The majority of patients were male (66.7%) and median age was 63.1 years. The most common etiologies were malignancy (23.8%), surgery (40.5%), chronic hepatic disease (19%) and heart failure (9.5%). Regarding to mortality, in-hospital mortality was mostly observed in surgical cases and those due to neoplastic disease, while out-of-hospital mortality was mostly due to progression of chronic hepatic disease or heart failure.
CONCLUSIONSː Chylous ascites is a diagnosis frequently overlooked; its incidence is increasing due to longer life expectancy and increased incidence of malignancies and other comorbidities such as chronic hepatic disease and heart failure. It may have deleterious consequences such as immunosuppression and malnutrition, which may contribute to the observed high mortality rate.

KEY WORDS: Chylous ascites; Triglycerides; Mortality