Primary Chylopericardium and its Surgical Treatment

Naef, A P

doi:10.1378/chest.30.2.160

Cited by 21 publications

(6 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Lymphatic vessels of the heart drain the pericardial fluid into the left subclavian vein via the mediastinal lymph vessels, lymph nodes and the thoracic duct (10). The main lymphatic flow from the pleura, the lower portion of the left lung, and the entire right lung and pericardium meet at the bronchomediastinal lymphatics (11,12). Therefore, lymphatic flow regurgitation can occur simultaneously in multiple sites in the thoracic cavity, such as the pleura, lungs and pericardium.…”

Section: Discussionmentioning

confidence: 99%

Primary chylopericardium: A case report and literature review

Xue

Jia

et al. 2017

Exp Ther Med

View full text Add to dashboard Cite

Abstract. Primary chylopericardium (CP) is a rare clinical condition in which chylous fluid containing high concentrations of triglyceride accumulates in the pericardial cavity. The present study reports a case of CP that was successfully treated by reconstruction surgery of thoracic duct. To improve the ability to diagnosis and treat this rare disease, the current study also systematically extracted 104 reported cases of primary or idiopathic CP from the past 60 years (January 1950 to December of 2015), and reviewed the clinical manifestation, etiology, diagnosis and treatment of these cases. The age at diagnosis varied between 6 weeks and 79 years with a mean age of 27.95±16.50 years. Asymptomatic patients accounted for 39.42% of cases, while the most common initial symptoms were dyspnea (44.23%) and coughing (10.58%). Jugular venous distention and distant heart sound was identified in 23 (22.12%) and 34 cases (32.69%), respectively. Cardiomegaly in X-ray scans was detected in the majority of patients (93.27%). In addition, lymphoscintigraphy and lymphangiography were helpful in identifying the source of chyle. Regarding the etiology, idiopathic cases accounted for 35.56% of the included cases in the present study. The most important cause of primary CP was abnormal connection or accumulation of lymph fluid in the pericardium (37.50%). Conservative therapy included low-fat or medium-chain triglyceride diet, as well as total parenteral nutrition. The majority of patients (71.2%) required surgery for definitive therapy, and thoracic duct ligation was the most preferred surgical procedure, performed in 44.23% of cases. Follow-up was reported in 64 cases, and all patients survived during the mean follow-up period of 12 months. Therefore, it is suggested that surgical management is the most successful treatment method and is associated with a favorable prognosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Primary chylopericardium: A case report and literature review

Xue

Jia

et al. 2017

Exp Ther Med

View full text Add to dashboard Cite

show abstract

“…Most reports concerning lymph or chyle within the pericardial space concern isolated patients because this condition is rare (38). Chylopericardium, i.e., milky effusion, most commonly results from obstruction or injury of the thoracic duct (39).…”

Section: Lymphatic and Chylous Effusionmentioning

confidence: 99%

“…Chylopericardium, i.e., milky effusion, most commonly results from obstruction or injury of the thoracic duct (39). At other times, its cause is not discernible but, nevertheless, hemipericardiectomy and ligation of pericardial lymphatics may result in disappearance of the chylous effusion (38). Lymphangiomatous hamartoma (cystic hygroma) of the mediastinum associated with a communication between the thoracic duct and pericardial space (40) also has caused chylopericardium.…”

Section: Lymphatic and Chylous Effusionmentioning

confidence: 99%

Pericardial Heart Disease: Its Morphologic Features and Its Causes

Roberts¹

2005

Baylor University Medical Center Proceedings

View full text Add to dashboard Cite

“…No r-eaccumulationl of fluiid (or chyle) was noted 6 months after surgery and the patient was asymptormatic (fig. 4) Although the other five patients whose cases have l)een reported also presented with relatively mild symptoms early in the course of the disease, they all progressed witli time to the state of cardiac tamponade with disabling and serious manifestations.1 5 From the date of diagnosis to surgery, a period of 13 moniths, our patient had uindergonie eight pericardioceliteses in the following periods: Oc- In three of the reported cases1-3 lymphangiomatous hamartomas were found, but no causative pathology could be found in the other four.4-7 In the case reported by Naef,4 there was a history of recent trauma and of an inflammatory process but there were no pathological findings on surgery to implicate or suggest either as the cause.…”

mentioning

confidence: 75%

Chronic Primary Chylopericardium

et al. 1967

View full text Add to dashboard Cite

SUMMARYThe case of a 36-year-old white man who had recurrent milky pericardial effusion and repeated pericardiocenteses over a period of 1 year with minimal disability or symptoms is presented. Surgical management included thoracotomy with ligation of all structures resembling lymphatic channels in the chest in several places and hemipericardiectomy. Neither the source of chyle in the pericardium nor the etiological agent of this condition could be found. Criteria for successful management of this condition are re-emphasized.

show abstract

Primary Chylopericardium and its Surgical Treatment

Cited by 21 publications

References 6 publications

Primary chylopericardium: A case report and literature review

Primary chylopericardium: A case report and literature review

Pericardial Heart Disease: Its Morphologic Features and Its Causes

Chronic Primary Chylopericardium

Contact Info

Product

Resources

About