Chylous ascites is when chyle collects in the belly. Chyle is a milky fluid made
in the bowels (intestines)
Depending the cause, doctors can treat chylous ascites (KYE-lus uh-SYE-teez) and
often cure it.
What Happens in Chylous Ascites?
Chyle (KYE-ul) is made of lymph and tiny fat droplets. Lymph (LIMF) is a clear
fluid that carries fats and proteins, helps fight germs,
and keeps the body's fluid levels normal.
Lymph vessels take chyle to the bloodstream. From there, the blood carries lymph
and fats where they are needed.
When the lymphatic
system is damaged or isn't working as it should, this normal flow can't happen.
The chyle can't get into the blood, and instead leaks into other places. In chylous
ascites, it leaks into the belly.
What Are the Signs & Symptoms of Chylous Ascites?
While there's only a little fluid in the belly, chylous ascites may not cause any
symptoms. But as the fluid builds up, it can cause:
Kids with chylous ascites also can have trouble fighting infections and may get
What Causes Chylous Ascites?
Children with the condition usually have it because of:
a problem in the lymphatic system that the child is born with
trauma that injures the lymphatic vessels
Less often, a child may get it after belly surgery, from cancer, or from other
How Is Chylous Ascites Diagnosed?
Before a baby is born, doctors might suspect chylous ascites when a routine prenatal ultrasound
shows fluid in the baby's belly. They'll do more tests to be sure.
In infants and children, doctors test the fluid in the belly. They use a needle
to take a sample and send it to a lab for testing. If the fluid has chyle, they'll
do other tests to find out how it's getting into the belly, such as an X-ray, ultrasound,
CT scan, or MRI.
If they need more information, doctors can do minimally
invasive surgery (laparoscopy). They make small cuts in the belly and use a tiny
camera and instruments to look for problems.
How Is Chylous Ascites Treated?
If a fetus has chylous ascites, doctors will watch the mother's pregnancy closely.
When she gives birth, they'll care for the baby in the NICU.
Treating the condition depends on what's causing it. Chylous ascites caused by
a leak in the lymphatic system may heal on its own.
Treatment, if needed, may include:
removing fluid from the belly with a needle
placing a drain in the belly so the fluid can flow out
helping the body make less chyle with medicine, a low-fat diet, or IV
nutrition (total parenteral nutrition, or TPN)