Chyle
Encyclopedia
Chyle is a milky bodily fluid
Bodily fluid
Body fluid or bodily fluids are liquids originating from inside the bodies of living people. They include fluids that are excreted or secreted from the body as well as body water that normally is not.Body fluids include:-Body fluids and health:...

 consisting of lymph
Lymph
Lymph is considered a part of the interstitial fluid, the fluid which lies in the interstices of all body tissues. Interstitial fluid becomes lymph when it enters a lymph capillary...

 and emulsified fat
Fat
Fats consist of a wide group of compounds that are generally soluble in organic solvents and generally insoluble in water. Chemically, fats are triglycerides, triesters of glycerol and any of several fatty acids. Fats may be either solid or liquid at room temperature, depending on their structure...

s, or free fatty acid
Fatty acid
In chemistry, especially biochemistry, a fatty acid is a carboxylic acid with a long unbranched aliphatic tail , which is either saturated or unsaturated. Most naturally occurring fatty acids have a chain of an even number of carbon atoms, from 4 to 28. Fatty acids are usually derived from...

s (FFAs). It is formed in the small intestine
Small intestine
The small intestine is the part of the gastrointestinal tract following the stomach and followed by the large intestine, and is where much of the digestion and absorption of food takes place. In invertebrates such as worms, the terms "gastrointestinal tract" and "large intestine" are often used to...

 during digestion of fatty foods, and taken up by lymph vessels specifically known as lacteals. The relative low pressure of the lacteals allows large fatty acid molecules to diffuse into them, whereas the higher pressure in veins allows only smaller products of digestion, like amino acids and sugars, to diffuse into the blood directly.

Pathology

A chyle fistula
Fistula
In medicine, a fistula is an abnormal connection or passageway between two epithelium-lined organs or vessels that normally do not connect. It is generally a disease condition, but a fistula may be surgically created for therapeutic reasons.-Locations:Fistulas can develop in various parts of the...

 is a leakage of lymphatic fluid from the lymphatic vessels, typically accumulating in the thoracic or abdominal cavities.

Treatment of a chyle fistula relies on ligation of the duct. This is because direct repair is impractical owing to the extreme friability
Friability
Friability is the ability of a solid substance to be reduced to smaller pieces with little effort. The opposite of friable is indurated....

 of the thoracic duct.

An alternative treatment is the subcutaneous use of the drug octreotide
Octreotide
Octreotide is an octapeptide that mimics natural somatostatin pharmacologically, though it is a more potent inhibitor of growth hormone, glucagon, and insulin than the natural hormone...

 (a synthetic analogue of somatostatin
Somatostatin
Somatostatin is a peptide hormone that regulates the endocrine system and affects neurotransmission and cell proliferation via interaction with G-protein-coupled somatostatin receptors and inhibition of the release of numerous secondary hormones.Somatostatin...

). This can lead to complete resolution of production of chyle, and avoids the need for surgery.
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