Management of chylopericardium

Use of octreotide in the treatment of chylopericardium

“…4 Surgical options include video-assisted thoracoscopic surgery, open thoracotomy, thoracic-duct ligation with a pericardial window, or pericardialperitoneal shunting. [5][6][7] Octreotide is a long-acting somatostatin analog that acts directly on vascular somatostatin receptors and minimizes lymph-fluid excretion. It also reduces lymphatic flow indirectly by increasing splanchnic arteriolar resistance and decreasing gastrointestinal blood flow.…”

Transabdominal ligation of the thoracic duct with pericardial-peritoneal shunting in a case of primary idiopathic chylous pericardial effusion

“…Previous studies have shown that reduction of lymphatic flow by octreotide if effective, is evident within 3 to 6 days 6 days after initiation of treatment; in our patient, this was not the case [12][13][14]. This treatment is considered a conservative one in which reestablishment of fluid in the pericardial cavity occurs in most cases [1,15,16]. Surgical management is important in cases where conservative therapy does not reduce pericardial drainage significantly or if there is a recurrence of the effusion [1,17].…”

Chylopericardial tamponade secondary to superior vena cava thrombosis in a child with nephrotic syndrome

“…The initial therapy for chylous effusion is decompression with low fat or MCT-rich oil oral alimentation [12,13]. Dietary modification decreases the lymph leak and provides adequate nutrition.…”