Idiopathic Thoracic Duct Stenosis Causing Chylopericardium: Report of a Case
Other Title
原發性乳糜管狹窄引起心包膜乳糜腫：病例報告
Journal
Formosan Journal of Surgery
Journal Volume
39
Journal Issue
1
Pages
43
Date Issued
2006
Author(s)
Po-Chih Cheng
Abstract
Chylopericardium, a condition in which chylous fluid accumulates in the pericardial cavity, can be primary, or secondary to cardiac surgery or trauma. In recent years, a few reports have been published, in which an abnormality in the lymphatic system is presumed to be the cause of primary chylopericardium. Here we report a case of such chylopericardium occurring in a previously healthy 18- year-old man. Although there was no history of trauma, infection or neoplasm, he was found to have an enlarged cardiac silhouette. Primary chylopericardium was diagnosed when pericarcliocentesis yielded characteristic milky-white fluid. The thoracic duct was identified preoperatively by lymphangiography, which showed stenosis in the brachiomediastinal area near the left subclavian vein. The chylopericardium was unresponsive to conservative treatment with pericardial drainage and medium chain triglyceride diet. Re-anastomosis of the thoracic duct into the left subclavian vein with establishment of a pericardial window through a left thoracotomy was performed. After the operation, no more milky-white fluid was found in the pericardial space. The present case is probably the first one treated by the thoracic duct reconstruction described in this communication via thoracotomy. A brief review of the literature is presented.
SDGs
Publisher
臺灣外科醫學會
Type
journal article