Primary idiopathic chylopericardium (PIC) is an uncommon cardiologic disorder; it is defined as accumulation of lymph in the pericardial sac without any know precipitating factor. A 25-year-old presented with dyspnea and chest pain for over two months. The patient underwent a chest X-ray, which revealed an enlargement of cardiac silhouette and signs of cardiac tamponade. Chest CT was performed, revealing large pericardial effusion and small pleural effusion on the right hemithorax. The patient was referred to the ICU and underwent a pericardial window through VATS, which revealed 500 ml of a milky fluid.
An 88-year-old woman diagnosed with COVID-19 in Brazil presented with recurrent pneumothorax. She was under mechanical ventilation for 20 days because of acute respiratory distress syndrome (ARDS). Chest x-ray revealed right lung pneumothorax, which was treated with a pigtail chest tube leading to successful lung reexpansion. After 48 hours the patient developed an ipsilateral pneumothorax and a new tube thoracostomy under conventional chest tube under suction was performed and kept in place for 14 days.
This brief report highlights that the conventional chest tube under suction procedures might be a good choice in Covid-19 patients.
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