ABSTRACT
“Chylous reflux” represents the abnormal direction of the chyle flow, either backward (backflow) or forward through other directions (diverted flow), thus appearing in various conditions of chylorrhea (chyle leakage) through the fistulas (lymphangiectasia), capillary microcystic malformations (lymphangiomatosis), or mesothelium (pleura, peritoneum) or epithelia (intestine mucosa, skin), or as a collection in cavities. Most commonly, chyle leakage is into the peritoneal cavity (chylous ascites) or pleural space (chyloperitoneum). But the leakage also results in chyluria (chyle in the urine), chyloptysis (chyle in the sputum), chylopericardium, or cutaneous chyle leakage. The general treatment strategy for chylous reflux/chylorrhea should be based on a dietary regimen to reduce fatty acid metabolism with appropriate modification of enteral nutrition with either a nonfat or a low-fat diet and medium-chain triglycerides. If such nutritional measures alone are not sufficient, additional medical (e.g., octreotide, sirolimus) or various modalities of surgical interventions including bypass reconstruction should be considered.
