Chylous Reflux

Abstract

The investigations and clinical courses of 19 patients with primary lymphatic disease who experienced chylous complications have been tabulated and analysed. They were found to fall into two groups or syndromes. Syndrome I.-Chylous reflux with megalymphatics. These patients usually had lymphoedema of one lower limb, large incompetent lymphatics, and chylous fistulae. Many of them had congenital naevi on the skin. They were treated by ligation and excision of incompetent megalymphatics. Their general prognosis is good. Syndrome II.—Chylous reflux with lymphatic deficiency. These patients had congenital or very early lymphoedema of several limbs, chylous effusions, and hypoproteinaemia. Lymphangiography showed extensive aplasia or hypoplasia of the lymphatic system. The prognosis in this group appears to be worse than in syndrome I. Detailed case reports are recorded elsewhere and references given. © 1964, British Medical Journal Publishing Group. All rights reserved.