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Successful thoracic duct embolisation in a child with recurrent massive pericardial effusion diagnosed as a lymphatic

Jue Seong Lee1, Mi Kyoung Song2, Saebeom Hur3

  • 1Department of Pediatrics, Korea University College of Medicine and Korea University Medical Center, Seoul, South Korea.

Cardiology in the Young
|February 25, 2020
PubMed

Insights

A rare case of massive pericardial effusion in a child was diagnosed using magnetic resonance lymphangiography. Percutaneous embolisation of the thoracic duct successfully treated this lymphatic abnormality.

Area of Science:

  • Cardiology
  • Radiology
  • Pediatrics

Background:

  • Idiopathic massive pericardial effusion is rare in children.
  • Pulmonary lymphangiectasia can be associated with lymphatic abnormalities.

Observation:

  • A 29-month-old girl presented with chronic, recurrent massive pericardial effusion.
  • CT imaging suggested pulmonary lymphangiectasia, prompting further investigation.
  • Magnetic resonance lymphangiography revealed thoracic duct dilation and chylolymphatic reflux into the pericardial space.

Findings:

  • The condition was diagnosed as primary chylopericardium with lymphangiectasia.
  • Initial thoracic duct embolisation led to immediate resolution of pericardial effusion.
  • Recurrence was successfully treated with additional embolisation of collateral lymphatic vessels.

Implications:

  • Magnetic resonance lymphangiography is a valuable tool for diagnosing complex lymphatic disorders.
  • Percutaneous embolisation offers a minimally invasive treatment option for chylopericardium.
  • This case highlights the importance of considering lymphatic abnormalities in pediatric pericardial effusion.

Keywords:
Pericardial effusionlymphatic anomalythoracic duct embolisation

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