The term chylous reflux refers to the backflow of chyle from its normal route, i.e., from the bowel lacteals through the cisterna chyli and the thoracic duct to the bloodstream. “Primary” chylous reflux suggests the absence of an apparent etiology, in contradistinction to those “secondary” cases in which an underlying etiology such as irradiation, neoplasia, trauma, or filariasis can be identified. The latter varieties are excluded from this review which, hence, concerns itself solely with the gynecological pertinence of idiopathic (primary) disorders of the chylous circulation. A case of chylometrorrhea (chylous uterine discharge) due to filariasis is mentioned only for the sake of completeness, since nematode-mediated disease is virtually unheard of in Europe or North America (1).Although exceptionally rare, primary chylous disorders must be considered in cases of profuse leukorrhea and unexplained vulvar edema or vesicle formation. A detailed discussion of this unique disorder is offered in the hope of contributing to a more rational management of such patients.
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