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The presence of chylomicrons rich in triglycerides in the peritoneal cavity cause the effluent to become milky. The potential pathogenesis of chyloperitoneum is the interruption of lymphatic drainage from the gut to the main lymphatic trunks. This could occur spontaneously, particularly in neonates, or as a result of tuberculous peritonitis, lymphoma or radiation therapy.
Diagnosis and Management. The diagnosis is suspected by the presence of a milky peritoneal outflow in the absence of any other signs or symptoms of peritonitis. Confirmation rests on positive stains of the supernatant for fat with Sudan black and dialysate triglyceride levels exceeding plasma triglyceride concentrations. Therapy consists of elimination of the causative condition if possible, or temporary cessation of PD and a diet of medium-chains fatty acids.
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