| 摘要 |
Chylopericardium, a condition in which chylous fluid accumulates in the pericardial
cavity, can be primary, or secondary to cardiac surgery or trauma. In recent years, a
few reports have been published, in which an abnormality in the lymphatic system is
presumed to be the cause of primary chylopericardium.
Here we report a case of such chylopericardium occurring in a previously healthy 18-
year-old man. Although there was no history of trauma, infection or neoplasm, he
was found to have an enlarged cardiac silhouette. Primary chylopericardium was
diagnosed when pericardiocentesis yielded characteristic milky-white fluid. The thoracic
duct was identified preoperatively by lymphangiography, which showed stenosis
in the brachiomediastinal area near the left subclavian vein. The chylopericardium
was unresponsive to conservative treatment with pericardial drainage and medium
chain triglyceride diet. Re-anastomosis of the thoracic duct into the left subclavian
vein with establishment of a pericardial window through a left thoracotomy was performed.
After the operation, no more milky-white fluid was found in the pericardial
space. The present case is probably the first one treated by the thoracic duct reconstruction
described in this communication via thoracotomy. A brief review of the literature
is presented. |
