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Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
Chylopericardial tamponade complicating oesophago-gastrectomy
Duncan Stewart1, Timothy Chico, Roger Ackroyd
1Department of Upper GI Surgery, Royal Hallamshire Hospital, Sheffield, UK. duncan.stewart@sth.nhs.uk
Interactive Cardiovascular and Thoracic Surgery
|October 15, 2008
Summary
Chyle leak after oesophagectomy is a rare complication. This case highlights a unique instance where it led to life-threatening pericardial tamponade and cardiovascular compromise.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Gastroenterology
Background:
- Chyle leak is an uncommon but recognized complication following oesophagectomy, occurring in 2-4% of patients.
- The Ivor-Lewis oesophago-gastrectomy is a standard surgical procedure for oesophageal cancer.
Observation:
- A patient developed a chyle leak 13 days post-Ivor-Lewis oesophago-gastrectomy.
- The chyle leak resulted in the accumulation of chylous fluid within the pericardial sac.
Findings:
- The pericardial effusion led to significant pericardial tamponade.
- This tamponade caused severe cardiovascular compromise, a previously unreported sequela of chyle leak.
Implications:
- This case underscores the potential for severe, atypical complications from chyle leaks after oesophagectomy.
- Early recognition and management of chyle leak are crucial to prevent life-threatening sequelae like cardiac tamponade.
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