Poux J M, Bénévent D, Guiserix J, Le Meur Y, Lagarde C, Leroux-Robert C
Service de néphrologie, CHU Dupuytren, Limoges.
Nephrologie. 1994;15(3):201-5.
Chylous ascites is a rare clinical entity often secondary to a lymphoma. In peritoneal dialysis even mild chylous ascites can cause cloudiness of the peritoneal effluent and thus lead to early diagnosis. Twelve cases of chylous ascites (defined by the presence of chylomicrons) among 230 patients with chronic renal failure treated in two peritoneal dialysis centers (Limoges and Saint-Pierre de la Réunion) are reported. A malignancy was encountered in only two cases (a B-cell lymphoma and an ovarian cancer). In the other cases, a precise diagnosis was difficult to establish and was only presumed. Thus chylous effusion in seven cases seemed secondary to cirrhosis, chronic pancreatitis, systemic amyloïdosis or cardiac failure. In three cases the cause was unknown, although microtrauma due to the Tenckhoff catheter was highly suspected. Chylous ascites lasted more than two years in four cases. The long-term nutritional consequences did not justify a change in the method of dialysis.
乳糜性腹水是一种罕见的临床病症,常继发于淋巴瘤。在腹膜透析中,即使是轻度乳糜性腹水也可导致腹膜透析液浑浊,从而实现早期诊断。本文报告了在两家腹膜透析中心(利摩日和留尼汪圣皮埃尔)接受治疗的230例慢性肾衰竭患者中出现的12例乳糜性腹水(根据乳糜微粒的存在定义)。仅在2例患者中发现恶性肿瘤(1例B细胞淋巴瘤和1例卵巢癌)。在其他病例中,难以做出准确诊断,仅为推测性诊断。因此,7例乳糜性积液似乎继发于肝硬化、慢性胰腺炎、系统性淀粉样变性或心力衰竭。3例病因不明,尽管高度怀疑是由于Tenckhoff导管导致的微创伤。4例患者的乳糜性腹水持续超过两年。长期的营养后果并不足以证明需要改变透析方法。