Primary chylopericardium

Akamatsu, Hideki; Amano, Jun; Sakamoto, Tohru; Suzuki, Akio

doi:10.1016/0003-4975(94)91124-x

Cited by 66 publications

(57 citation statements)

References 35 publications

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“…Causes of CP include congenital mediastinal lymphangiectasia, iatrogenic development following cardiac surgery, malignant tumors, blunt or penetrating trauma, infection and congenital lymphatic anomalies (6,11,(13)(14)(15). It has been reported that ~56% of cases are idiopathic (6), and only ~100 CP cases have been reported worldwide (16).…”

Section: Discussionmentioning

confidence: 99%

Primary chylopericardium: A case report and literature review

Xue

Jia

et al. 2017

Exp Ther Med

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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.

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Section: Discussionmentioning

confidence: 99%

Primary chylopericardium: A case report and literature review

Xue

Jia

et al. 2017

Exp Ther Med

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“…According to Akamatsu et al, 11 ligation and resection of the thoracic duct and construction of a pericardial window is the most effective treatment to prevent the recurrence of chylous fluid accumulation.…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic Treatment for Primary Chylopericardium: Report of a Case

et al. 2005

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We used video-assisted thoracoscopic surgery to successfully treat primary chylopericardium, a very rare disease. A 27-year-old woman was admitted to our hospital for investigation of cardiomegaly and dyspnea on exertion. Echocardiography showed severe peri-cardial effusion. A milky fluid was extracted by pericardiocentesis and diagnosed as being chylous. A computed tomography (CT) scan taken after lymphangiography showed the leakage of contrast solution into the pericardial cavity. Initially, conservative therapy was used to treat the condition, but this proved ineffective and we decided to perform video-assisted thoracoscopic surgery. The thoracic duct was ligated and excised, and partial pericardiectomy was carried out under thoracoscopy. The patient has been in good health with no sign of recurrence since her operation. Thus, video-assisted thoracoscopic thoracic duct ligation and partial pericardiectomy can be effectively used to treat primary chylopericardium.

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“…6,7 Akamatsu et al presented 2 illustrative cases and an in-depth analysis of recurrence along with a suitable surgical procedure. 8 In their paper, they reported that in a collective review of the literature 2 in 22 patients who received ligation and resection of the thoracic duct and establishment of a pericardial window through a right thoracotomy showed reaccumulation of the chylous fluid. However, there was no reaccumulation of the chylous fluid in patients receiving left thoracotomy.…”

Section: Discussionmentioning

confidence: 99%