Chronic Swelling Over Cardiac Implantable Electronic Device Sites

An atypical pacemaker pocket hematoma containing chyliform fluid

“…have reported chyle collection in pacemaker pocket in a patient with a background of radiotherapy, where the local anatomy may have been altered, with the possibility of forming a fistula [ 4 ]. Other cases of chyloma were reported in patients with anomalous thoracic duct drainage into the left subclavian vein with injury during device implantation [ 5 ]. On the other hand, cases of chylothorax and chylopericardium due to obstruction of the brachiocephalic vein by the pacemaker leads have been reported, with superimposed thrombosis, and subsequent cascade of events that resulted in chyle leakage [ 6 ].…”

“…The presence of cholesterol crystals is virtually diagnostic of pseudochyle. [ [3] , [4] , [5] , [6] , [7] ] .…”