Abstract
Primary chylous pericardial effusion is a rare entity with few cases reported so far.
We report a case of idiopathic etiology in a previously healthy 16-year-old boy. The
patient presented with intermittent chest pain and dizziness caused by a chronic pericardial
effusion. An echocardiogram revealing a pericardial effusion and open pericardiocentesis
with a drainage of approximately of 500 ml of chylous fluid established the diagnosis. Patient had no history of trauma, cardiac
surgery, central insertion of subclavian catheters or blunt injury. Computed tomography
ruled out malignancies in the abdomen and chest. Clinical, laboratory and radiological
investigations for the possible underlying cause of the condition were not determined.
Management with a dietary regimen consisting of a medium-chain triglyceride-rich diet,
octreotide pharmacological treatment and initial subxiphoid resection with pericardial
tube drainage was unsuccessful. Surgical approach was required consisting of pericardio-peritoneal
window with trans-abdominal ligation (clipping) of the thoracic duct above the diaphragm.
Postoperative outcome was uneventful and there was a rapid recovery after surgical
management.
Key words
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Article info
Publication history
Accepted:
April 9,
2013
Received in revised form:
March 17,
2013
Received:
December 15,
2012
Footnotes
☆Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the editor-in-chief of this journal on request.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
