Northwell Health, New Hyde Park, New York.
J Emerg Med. 2020 Mar;58(3):e149-e152. doi: 10.1016/j.jemermed.2019.12.028. Epub 2020 Mar 20.
Chyluria is a rare condition where chyle is excreted into the urine. Clinically, most patients manifest with intermittent passage of milky urine. Patients may also present with dysuria, urinary frequency, urgency, retention, or with the sequelae of chronic malnutrition.
We present a 55-year-old African American man who presented to the emergency department complaining of milky white urine, dysuria, decreased urine output, and suprapubic abdominal pain once a day. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Patients may present to the emergency department complaining of milk-colored urine, hematuria, urinary retention, or the sequelae of malnutrition. Initial evaluations should include laboratory investigations of common causes of chyluria and the severity of the potential malnutrition. If the patient presents with urinary retention, after relieving the obstruction in the emergency department, assessment for clot/chyle burden and likelihood of recurrence of urinary retention should be performed by urology. Arrangements for proper outpatient follow-up should be made if the disease manifestations are not severe enough to warrant admission.
乳糜尿是一种罕见的病症，其中乳糜被排泄到尿液中。临床上，大多数患者表现为间歇性排出乳白色尿液。患者也可能出现尿痛、尿频、尿急、尿潴留，或出现慢性营养不良的后遗症。
我们介绍一位 55 岁的非裔美国男性，因乳白色尿液、尿痛、尿量减少和耻骨上腹部疼痛一天一次而到急诊科就诊。
为什么急诊医生应该了解这个问题？：患者可能因乳糜尿、血尿、尿潴留或营养不良的后遗症而到急诊科就诊。初步评估应包括对乳糜尿常见原因和潜在营养不良严重程度的实验室检查。如果患者出现尿潴留，在急诊科解除梗阻后，应通过泌尿科评估血块/乳糜负荷和尿潴留复发的可能性。如果疾病表现不足以住院治疗，应安排适当的门诊随访。
