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Idiopathic chylopericardium treated by percutaneous thoracic duct embolization after failed surgical thoracic duct

Malachi Courtney1, Raj R Ayyagari

  • 1Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, USA.

Pediatric Radiology
|September 25, 2014
PubMed

Insights

Primary idiopathic chylopericardium in children is rare. Percutaneous thoracic duct embolization successfully treated a pediatric case resistant to surgical lymphatic ligation and pericardial window procedures.

Area of Science:

  • Pediatric Cardiology
  • Interventional Radiology
  • Thoracic Surgery

Background:

  • Chylopericardium is a rare condition in children, often resulting from cardiothoracic surgery.
  • Primary idiopathic chylopericardium is exceptionally uncommon, with limited pediatric case reports.

Observation:

  • A 10-year-old boy presented with primary idiopathic chylopericardium.
  • Initial treatment with surgical lymphatic ligation and a pericardial window was unsuccessful.
  • The patient later developed a right-side chylothorax due to pericardial window effluent.

Findings:

  • Successful treatment was achieved through interventional radiology using percutaneous thoracic duct embolization.
  • This minimally invasive approach resolved the chylopericardium and subsequent chylothorax.
  • The procedure served as a salvage therapy after surgical intervention failure.

Implications:

  • Thoracic duct embolization is a valuable, less-invasive alternative to surgical thoracic duct ligation.
  • This technique offers a potential salvage option for refractory pediatric chylopericardium.
  • Highlights the importance of interventional radiology in managing complex pediatric thoracic conditions.

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