Primary idiopathic chylopericardium associated with cervicomediastinal cystic hygroma

Byoung Chul Cho, Seok Min Kang, Seung Chul Lee, Jeong Geun Moon, Dong Hyung Lee, Sang Hyun Lim

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Chylopericardium is a rare clinical entity in which chylous fluid accumulates in the pericardial cavity. We report a case of primary idiopathic chylopericardium associated with multiple, small cervicomediastinal cystic hygromas occurring in an asymptomatic 43-year-old woman with no history of trauma, thoracic surgery, malignancy, infection or tuberculosis. Echocardiography showed a large amount of pericardial effusions and pericardial fluid analysis revealed inappropriately elevated triglyceride. We did not demonstrate communication between the thoracic duct and the pericardial sac by lymphangiography and chest computed tomography. She successfully responded to 30 days of continuous pericardial drainage and 15 days of a medium-chain triglyceride diet after 30 days of total parenteral nutrition. Follow-up echocardiography 6 months after treatment commencement showed a minimal reaccumulation of pericardial fluid without symptom. We conclude that if a patient is asymptomatic and can well tolerate daily life, surgery including pericardiectomy or ligation of the thoracic duct is not necessarily required.

Original languageEnglish
Pages (from-to)439-444
Number of pages6
JournalYonsei medical journal
Volume46
Issue number3
DOIs
Publication statusPublished - 2005 Jun 30

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Cystic Lymphangioma
Pericardial Effusion
Thoracic Duct
Pericardium
Echocardiography
Triglycerides
Pericardiectomy
Lymphography
Total Parenteral Nutrition
Thoracic Surgery
Ligation
Drainage
Tuberculosis
Thorax
Communication
Tomography
Diet
Wounds and Injuries
Infection
Neoplasms

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Cho, Byoung Chul ; Kang, Seok Min ; Lee, Seung Chul ; Moon, Jeong Geun ; Lee, Dong Hyung ; Lim, Sang Hyun. / Primary idiopathic chylopericardium associated with cervicomediastinal cystic hygroma. In: Yonsei medical journal. 2005 ; Vol. 46, No. 3. pp. 439-444.
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Primary idiopathic chylopericardium associated with cervicomediastinal cystic hygroma. / Cho, Byoung Chul; Kang, Seok Min; Lee, Seung Chul; Moon, Jeong Geun; Lee, Dong Hyung; Lim, Sang Hyun.

In: Yonsei medical journal, Vol. 46, No. 3, 30.06.2005, p. 439-444.

Research output: Contribution to journalArticle

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AU - Kang, Seok Min

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AU - Lim, Sang Hyun

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AB - Chylopericardium is a rare clinical entity in which chylous fluid accumulates in the pericardial cavity. We report a case of primary idiopathic chylopericardium associated with multiple, small cervicomediastinal cystic hygromas occurring in an asymptomatic 43-year-old woman with no history of trauma, thoracic surgery, malignancy, infection or tuberculosis. Echocardiography showed a large amount of pericardial effusions and pericardial fluid analysis revealed inappropriately elevated triglyceride. We did not demonstrate communication between the thoracic duct and the pericardial sac by lymphangiography and chest computed tomography. She successfully responded to 30 days of continuous pericardial drainage and 15 days of a medium-chain triglyceride diet after 30 days of total parenteral nutrition. Follow-up echocardiography 6 months after treatment commencement showed a minimal reaccumulation of pericardial fluid without symptom. We conclude that if a patient is asymptomatic and can well tolerate daily life, surgery including pericardiectomy or ligation of the thoracic duct is not necessarily required.

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