Chylopericardial Tamponade Accompanied by Chylothorax after Right Upper Lobectomy: A Rare but Fatal Postoperative...

Postoperative chylothorax after thoracic surgery is relatively rare, and cardiac tamponade accompanied by the former is a scarce phenomenon. Although there have been scarce reports of such cases in cardiac surgery, reports on general thoracic surgery are exceedingly rare.

A 57-year-old male with suspected lung cancer underwent right upper lobectomy and selective mediastinal lymph node dissection. Postoperatively, he developed chylothorax that was unresponsive to conservative management, and thoracic duct ligation was planned for postoperative day 13. However, on postoperative day 12, he experienced cardiopulmonary arrest secondary to chylopericardial tamponade. Although cardiac rhythm was restored by pericardiocentesis, resuscitation required 80 minutes. The patient ultimately died of multiple organ failure on postoperative day 23.

To our knowledge, this is the first report of postoperative death due to chylopericardial tamponade accompanied by postoperative chylothorax. Although this is a scarce complication, it can be fatal, and thoracic surgeons who perform pulmonary resection with mediastinal lymph node dissection should be aware of this phenomenon. In cases of postoperative chylothorax with concurrent pericardial effusion, the possibility of developing chylopericardial tamponade should be considered, and active consideration of pericardial drainage is recommended.