Chylopericardial Tamponade in a Patient with Chylothorax after Pulmonary Lobectomy.
10.4266/kjccm.2013.28.4.327
- Author:
Jin Sue JEON
1
;
Ho Geol RYU
;
Hannah LEE
;
Da Hye YOO
Author Information
1. Department of Neurosurgery, Seoul University Hospital, Seoul University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
chylopericardium;
chylothorax;
cardiac tamponade
- MeSH:
Cardiac Tamponade;
Cardiopulmonary Resuscitation;
Chyle;
Chylothorax*;
Echocardiography;
Extracorporeal Membrane Oxygenation;
Female;
Food Habits;
Humans;
Hypotension;
Ligation;
Lung Neoplasms;
Middle Aged;
Pericardial Effusion;
Pericardiocentesis;
Thoracic Duct
- From:The Korean Journal of Critical Care Medicine
2013;28(4):327-330
- CountryRepublic of Korea
- Language:English
-
Abstract:
Chylopericardium is a very rare, yet potentially fatal, complication following intrathoracic surgery, and can further lead to other life-threatening complications such as cardiac tamponade. A 54-year-old female underwent right upper lobectomy for lung cancer. Chylothorax developed on the 2nd postoperative day, and was managed conservatively with dietary modification. On the 9th postoperative day, the patient suddenly developed hypotension and severe cardiac dysfunction requiring cardiopulmonary resuscitation followed by VA ECMO. Transthoracic echocardiography revealed a large amount of pericardial effusion. Prompt pericardiocentesis was performed and the aspirated fluid showed features of chyle. Thoracic duct ligation with pericardial window operation was performed because the daily amount of chyle drained did not decrease after 3 weeks. Here, we review etiologies and therapeutic options of chylopericardial tamponade following intrathoracic surgery, which should not be underestimated even when the patient seems to demonstrate a good recovery.
