Transcription of When Chyle Leaks: Nutrition Management Options
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When Chyle Leaks: Nutrition Management Options
PRACTICAL GASTROENTEROLOGY MAY 200460 INTRODUCTIONC hyle is an alkaline, milky, odorless fluid that pro-vides about 200 kcal/liter. It contains greater than30 g/L of protein, 4 40 g/L of lipid (mostly triglyc-eride) and cells consisting primarily of lymphocytes (1). Chyle leaks are a rare complication; they can occur for avariety of reasons after injury to the intra-abdominallymphatics (Table 1). Leakage may manifest as a chy-lothorax or chylous effusion (thoracic cavity); chylousascites (peritoneal cavity); chylopericardium (cardiaccavity) or as an external draining fistula. Approximately60% of Chyle leaks are due to lymphoma; 25% due totrauma (iatrogenic or penetrating); other causes make upthe remaining 15% of cases (2). The incidence of chyleleaks varies depending on the underlying cause. Theincidence after radical neck dissection is 1 (3);after cardiothoracic surgery 1% (2). DIAGNOSISThe diagnosis of a Chyle leak is often subjective, anddiagnostic criteria may vary.
Stacey McCray (continued on page 62) Chylous leakage from the lymphatic system is a complex problem usually resulting from injury or abnormality of the thoracic duct. Although rar e, when such leaks occur, they are often difficult to manage and correct. Nutrition therapy plays a …
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