[An analysis of 30 cases of chylothorax and chyloperitoneum]

Thirty patients diagnosed as chylothorax and chyloperitoneum (13 of chylothorax, 9 of chyloperitoneum and 8 of both) in PUMC Hospital from 1923 to 1989 were reported. Thus, the incidence rate of these two diseases is rather low. The commonest causes were iatrogenic trauma (9 cases) and malignant tumor (7 cases). Other causes were tuberculosis (5 cases), lymphangioma (2 cases), Behcet's syndrome (1 case) and non-iatrogenic trauma (1 case). The etiology was not known in 5 cases. Acute episode was observed in patients with traumatic chylous effusion; it was usually manifested as dyspnea or abdominal distention. Patients with nontraumatic chylous effusion usually run a chronic course. The characteristics of chylous effusion were analyzed. Lymphangiography and lymphoscintigraphy with 99m TC-labeled dextran play important roles in diagnosis and treatment. It has been suggested that the changes in T-cell immunocompetence is important in determining whether the treatment should be conservative or operative. If chylous effusion is due to tuberculosis, antituberculosis treatment should be instituted.