Chyloperitoneum PD — ESENeph MCQ

Correct answer: C — Chyloperitoneum producing triglyceride-rich milky dialysis effluent after surgery

The best answer is “Chyloperitoneum producing triglyceride-rich milky dialysis effluent after surgery”. Chyle is triglyceride-rich lymph. Evaluation seeks malignancy, lymphatic obstruction, recent surgery, pancreatitis and other causes while preserving nutrition. “Bacterial peritonitis producing neutrophil-predominant cloudy dialysis effluent” is less appropriate because the normal cell count, negative culture and high triglycerides indicate another process “Fibrin precipitation producing strands within otherwise clear dialysis effluent” is less appropriate because fibrin produces strands or clots rather than triglyceride-rich milky fluid “Eosinophilic peritonitis producing eosinophil-rich cloudy dialysis effluent” is less appropriate because that requires an eosinophilic inflammatory cell pattern “Encapsulating peritoneal sclerosis producing obstruction and ultrafiltration failure” is less appropriate because EPS produces chronic obstruction and peritoneal thickening rather than isolated chylous effluent

Reference: UK Kidney Association peritoneal dialysis guideline: https://ukkidney.org/sites/default/files/final-peritoneal-dialysis-guideline667ba231181561659443ff000014d4d8.pdf