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Isolated primary chylopericardium.

H Akashi1, K Tayama, K Ishihara

  • 1Department of Surgery, Kurume University School of Medicine, Japan.

Japanese Circulation Journal
|March 20, 1999
PubMed
Summary
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This study details a successful surgical treatment for primary chylopericardium in a young patient. The procedure involved thoracic duct ligation and pericardiectomy, resolving pericardial fluid accumulation.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Medical Imaging

Background:

  • Primary chylopericardium is a rare condition characterized by milky-white fluid in the pericardial sac, often presenting with an enlarged cardiac silhouette.
  • Diagnosis is confirmed via pericardiocentesis, revealing characteristic chylous fluid.
  • Identifying the thoracic duct is crucial for surgical intervention.

Observation:

  • A 16-year-old male presented with an enlarged cardiac silhouette.
  • Pericardiocentesis confirmed primary chylopericardium.
  • The thoracic duct was visualized using oral fats and methylene blue dye.
  • Intraoperative thoracic ductography revealed no abnormalities.

Findings:

  • Surgical management included mass ligation of the thoracic duct above the diaphragm and partial pericardiectomy.

Related Experiment Videos

  • The procedure was performed via a right thoracotomy approach.
  • Additional ligation of lymphatic vessels superior to the diaphragm was performed.
  • The right thoracotomy approach proved effective for thoracic duct resection and ligation.

    • Implications:

    • This case highlights the efficacy of a right thoracotomy for thoracic duct and lymphatic ligation in managing primary chylopericardium.
    • Successful surgical intervention led to the resolution of pericardial fluid and pleural effusion.
    • The described surgical technique offers a viable treatment option for this rare condition.