Abstract
BackgroundChylous cardiac tamponade is a rare condition with little known cause.Case presentationA case of an otherwise healthy woman who admitted with dyspnea and palpitations is presented. She had a history of a painful flexion-hyperextension of the spine. Diagnostic evaluation proved a chylous pericardial effusion with a disruption of the anterior longitudinal spinal ligament. Video-assisted thoracic surgery with mass supradiaphragmatic ligation of the thoracic duct and pericardial window formation was carried out successfully and resulted in the complete cure of the patient's condition.ConclusionChylous pericardial effusion and subsequent tamponade is a rare entity. Endoscopic surgery is offering a safe and effective treatment.
Highlights
Chylous cardiac tamponade is a rare condition with little known cause.Case presentation: A case of an otherwise healthy woman who admitted with dyspnea and palpitations is presented
A case of spontaneous chylous cardiac tamponade which was successfully treated by video-assisted thoracic surgery (VATS) is reported
The patient underwent, a bipedal lymphangiography which showed no anatomic abnormalities of the thoracic duct and no leakage
Summary
Chylous pericardial effusion may occur following cardiothoracic surgery or in association with congenital lymphangiomatosis. A case of spontaneous chylous cardiac tamponade which was successfully treated by video-assisted thoracic surgery (VATS) is reported. A daily output of 350 ml of pericardial fluid led us to start total parenteral nutrition, subcutaneous octreotide and no oral feedings for 7 days. The patient underwent, a bipedal lymphangiography which showed no anatomic abnormalities of the thoracic duct and no leakage. The patient underwent a video-assisted supradiaphragmatic mass ligation of the thoracic duct and creation of a pleuropericardial window through a low right mini thoracotomy. There has been no recurrence of the pericardial effusion for 12 months
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