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Chyle

Milky bodily fluid consisting of lymph and emulsified fats

Field	Value
Name	Chyle
image	Chylothorax.jpg
caption	Chyle drained from someone with chylothorax, showing the characteristic milky appearance of the liquid.
system	Lymphatic system
location	Formed in the small intestine
Pronunciation

Chyle (; ) is a milky bodily fluid consisting of lymph and emulsified fats, or free fatty acids (FFAs). It is formed in the small intestine during digestion of fatty foods, and taken up by lymph vessels specifically known as lacteals. The lipids in the chyle are colloidally suspended in chylomicrons. Its principal role is to carry dietary fats and fat-soluble vitamins from the intestine into the venous circulation after digestion.

Clinical significance

A chyle fistula occurs when defect(s) of lymphatic vessel(s) result in leakage of lymphatic fluid, typically accumulating in the thoracic (pleural) or abdominal (peritoneal) cavities, leading to a chylous pleural effusion (chylothorax) or chylous ascites, respectively. Leakage of lymphatic fluid and decreased chyle volume result in the loss of fluid, electrolytes, proteins, and lymphocytes, leading to complications with nutrition, wound healing, and immunity.

Diagnosis of a chyle fistula may be accomplished by analysis of pleural/peritoneal fluid. Identifying the source (localizing the lymphatic defect) is often challenging, but may be accomplished with lymphangiography, which is occasionally associated with a serendipitous therapeutic effect (resolution of the leak), thought to be secondary to a sclerosant effect of the lymphangiography contrast.

Because of the extreme friability of the lymphatic vessels, direct repair of defects is impractical. Therefore, treatment of chyle fistulae relies upon either decreased production of lymphatic fluid to allow for healing of lymphatic defect(s) or permanent diversion of lymphatic fluid away from lymphatic defect(s). Decreased production of lymphatic fluid may be accomplished by dietary restriction (or complete replacement of oral intake with total parenteral nutrition), as well as by the medications octreotide (a synthetic analogue of the hormone somatostatin) and orlistat (a lipase inhibitor that decreases absorption of dietary fats). Permanent diversion of lymphatic fluid may be accomplished by thoracic duct embolization (a needle-based procedure to occlude the duct by depositing glue/embolic material into it) or by thoracic duct ligation (an open surgical procedure to occlude the duct by suturing tightly around it).

References

Mosby’s Medical, Nursing and Allied Health Dictionary, Fourth Edition, Mosby-Year Book Inc., 1994, p. 335
(February 29, 2024). "Chylothorax: pathophysiology, diagnosis, and management—a comprehensive review". Journal of Thoracic Disease.
Tessier, Deron J, MD, [http://www.emedicine.com/med/topic2706.htm Chyle fistula] eMedicine; Jan 10, 2008; accessed Feb 2008
Sriram, K., Meguid, R. A., & Meguid, M. M. (2016). Nutritional support in adults with Chyle Leaks. Nutrition, 32(2), 281–286. https://doi.org/10.1016/j.nut.2015.08.002
(2005). "The successful treatment of chylous effusions in malignant disease with octreotide". Clinical Oncology.

Info: Wikipedia Source

This article was imported from Wikipedia and is available under the Creative Commons Attribution-ShareAlike 4.0 License. Content has been adapted to SurfDoc format. Original contributors can be found on the article history page.

body-fluids digestive-system lymphatic-system

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