Quilopericárdio idiopático

Fernandes, Fábio; Arteaga, Edmundo; Carvalho, Mauro Sérgio Stateri; Ianni, Bárbara Maria; Fernandes, Paulo Pego; Mady, Charles

doi:10.1590/s0066-782x1998000800007

Cited by 5 publications

(8 citation statements)

References 3 publications

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“…Chylopericardium is an entity defined as the accumulation of chylous fluid in the pericardial space. It is typically the result of chest trauma [7], thoracic surgical procedures [8], mediastinal radiotherapy, mediastinal neoplasms [7,8], signet-ring cell carcinoma of the stomach [10], mediastinal tuberculosis, filariasis, thrombosis of the subclavian vein [7] and vena cava [11], Behcet's syndrome [12], congenital lymphangiomatosis, Gorham-Stout disease (osteolysis secondary to lymphangiomatosis with bone resorption) [13], congenital mediastinal lymphangiectasia and congenital lymphatic anomalies [12]. A recent case report describes a unique case of chylothorax and chylopericardium in end stage renal disease patient on hemodialysis with a left jugular tunneled catheter who developed superior vena cava syndrome [3], thus increasing the etiology of this illness.…”

Section: Discussionmentioning

confidence: 99%

“…Pericardiocentesis with pericardial fluid drainage prevents mechanical complications by reducing intrapericardial pressure, improving preload and, therefore, systolic volume. A low-fat diet decreases the formation of chylopericardium and medium-and short-chain triglyceride supplementation is required for their preferential absorption through the portal vein rather than via the lymphatic vessels [11]. Total parenteral nutrition has been described as the method of choice for nutritional therapy as enteral nutrition promotes the formation of chyle.…”

Section: Discussionmentioning

confidence: 99%

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Primary Idiopathic Chylopericardium as Unusual Cause of Cardiac Tamponade

Aranalde¹,

Lorenzin²,

Cánaves³

et al. 2019

AJIM

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The chylopericardium is defined as the accumulation of chylous fluid containing high concentrations of triglycerides in the pericardial space. It is quite an uncommon condition first described in 1888 by Hasebroek. The absence of an underlying etiology defines it as primary idiopathic chylopericardium, term initially used in a study by Groves and Effler in 1954. Even when most patients are asymptomatic, constrictive pericarditis or cardiac tamponade may be referred. Cardiac tamponade, the most serious complication, represents an entity characterized by fluid accumulation in the pericardial cavity. Claudius Galen from Pergamum (131-201 D. C.) described pericardial effusions in gladiators with stab injuries of the chest and Richard Lowe (1669) described its physiology. It took two hundred years for the term "cardiac tamponade" was coined by german surgeon Edmund Rose. Cardiac tamponade can be presented from asymptomatic setting to life-threatening conditions. By the former reason, the early recognition of this entity has crucial importance. Idiopathic chylopericardium occurs in all age groups and affects both sexes equally. Although several mechanisms have been proposed in order to explain the development of chylopericardium, the underlying pathophysiology remains unclear. Damaged lymphatic vessels with abnormal communication of the thoracic duct to the pericardial lymphatics and elevated pressure in the thoracic duct can justify the presence of chyle into the pericardial sac. Diagnosis is confirmed by pericardiocentesis which must reveal at least two of the classical five criteria. Chylopericardium may be managed through conservative or surgical treatment. The conservative treatment consist a medium chain triglyceride diet or total parenteral nutrition but has a high degree of recurrence, for which reason the safest option is thoracic duct ligation with a pericardial window. The present study reports a case of chylopericardium wherein the leak was diagnosed by lymphoscintigraphy that was successfully treated by a low-fat diet, rich in medium-chain triglycerides and octreotide infusion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Primary Idiopathic Chylopericardium as Unusual Cause of Cardiac Tamponade

Aranalde¹,

Lorenzin²,

Cánaves³

et al. 2019

AJIM

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“…The most common symptoms are dyspnea, fatigue and cough 5 . vessels using lymphoscintigraphy is indicated, because it helps identify lymphopericardial fistulas, anatomical variations or partial aplasia of the thoracic duct 3,5,9 . Computed tomography scan may be useful to rule out lymphangiomatosis.…”

Section: Discussionmentioning

confidence: 99%

“…In the postoperative period, the volume drained remained between 150 and 400 ml/day (mean of 240 ml/day) for 15 days, to further decrease until it ceased completely on day 30. The pathophysiology of primary chylopericardium may be related to an abnormal connection between the thoracic duct and the pericardium, with the presence of fistulas, chyle reflux associated with lymphatic hypertension with loss of the valve mechanism and increased permeability of lymphatic vessel walls 3 .…”

Section: Hospital Coursementioning

confidence: 99%

“…This is a rare clinical entity in which chyle accumulates in the pericardial cavity [1][2][3] . It may be caused by surgical trauma, irradiation, tuberculosis, caval obstruction, and primary or metastatic mediastinal tumors 1,[3][4][5] . The pathophysiology common to all these conditions seems to be thoracic duct obstruction without development of collateral drainage 4 .…”

Section: Introductionmentioning

confidence: 99%

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Quilopericárdio idiopático primário: relato de caso

Silva¹,

Martins²,

Campos³

et al. 2009

Arq. Bras. Cardiol.

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Pericardial effusions; chylopericardium idiopathic primary.The accumulation of chyle in the pericardial space, or chylopericardium, is a condition occurring most frequently after trauma, cardiac and thoracic surgery, or in association with tumors, tuberculosis or lymphangiomatosis. When its precise cause cannot be identified, it is called primary or idiopathic chylopericardium. This is a rare clinical entity. We report the case of a surgically treated 20-year-old female patient. A brief review of the literature and comments on the clinical presentation, etiopathogenesis, ancillary diagnostic tests and treatment options are also presented.Pericardial biopsy -fibrous thickening and mesothelial reaction. Laboratory tests:Blood -total cholesterol 140 mg/dl; LDL-cholesterol 62 mg/dl; triglycerides 70 mg;dl.Pericardial fluid -triglycerides 1,420 mg/dl; culture-sterile; Gram-staining-absence of bacteria, rare leukocytes; cytology -global count: erythrocytes 2.6 x 10 3 /mm 3 ; leukocytes 3.2 x 10 3 /mm 3 ; differential count: lymphocytes 3%; monocytes 8%; segmented neutrophils 89%.Lymphoscintigraphy performed 14 days after pericardial drainage showed lower limbs with normal aspect and abnormal thoracic radiopharmaceutical accumulation, which e40 Case Report Silva et al Primary idiopathic chylopericardium Arq Bras Cardiol 2009; 92(6) : e40-e43 Primary idiopathic chylopericardium Arq Bras Cardiol 2009; 92(6) : e40-e43

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Chylopericardium mit Vena-subclavia-Thrombose

Kanko¹,

Liman²,

Topçu³

et al. 2005

Phlebologie

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ZusammenfassungIn dieser Kasuistik stellen wir einen Fall mit beidseitigem Chylothorax und Perikardtamponade aufgrund eines durch eine Thrombose der Vena subclavia verursachten Chylus vor, der als Ergebnis einer Phlegmone im Achselhöhlenbereich aufgetreten ist. Unseres Wissens wurden bisher bei keinem Fall solche kausalen Faktoren in der Literatur berichtet. Unser Fall wird mit wiederholter Thorakozentese und Anwendung von Perikard-Drainagen behandelt. Was immer die Ursache ist, die Perikardflüssigkeit muss bei einer Thrombose der linken Vena subclavia untersucht werden. Wird ein Chyloperikard bei seiner Entdeckung mit den geeigneten Methoden rechtzeitig behandelt, können die fatalen Komplikationen, die sonst entstehen könnten, verhindert werden.

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Quilopericárdio idiopático

Cited by 5 publications

References 3 publications

Primary Idiopathic Chylopericardium as Unusual Cause of Cardiac Tamponade

Primary Idiopathic Chylopericardium as Unusual Cause of Cardiac Tamponade

Quilopericárdio idiopático primário: relato de caso

Chylopericardium mit Vena-subclavia-Thrombose

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