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Chylopericardial Tamponade in a Patient with Chylothorax after Pulmonary Lobectomy
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Jin Sue Jeon, Ho Geol Ryu, Hannah Lee, Da Hye Yoo
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Korean J Crit Care Med. 2013;28(4):327-330.
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DOI: https://doi.org/10.4266/kjccm.2013.28.4.327
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 Abstract
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- 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.
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Citations
Citations to this article as recorded by  - A Case of Chylopericardium Caused by Chylous Pleural Effusion Inflow from a Damaged Pericardium during Operation for Right Lung Cancer
Masahiro MATSUNO, Kyo HIRAYAMA, Nobuo TSUNOOKA
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2023; 84(6): 868. CrossRef - A case of cardiac tamponade caused by chylopericardium after mediastinal lymph node dissection for recurrence of lung cancer
Shinsuke Kitazawa, Kojiro Nakaoka, Naohiro Kobayashi, Shinji Kikuchi, Yukinobu Goto, Yukio Sato
The Journal of the Japanese Association for Chest Surgery.2017; 31(2): 181. CrossRef - Isolated Chylopericardium after Mitral Valve Replacement: the First Description of Adult Heart Disease in Korea
Su Wan Kim, Seogjae Lee
Korean Journal of Critical Care Medicine.2014; 29(2): 123. CrossRef
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Management of Upper Extremity Deep Vein Thrombosis with a Superior Vena Cava Filter - A Case Report -
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Wooil Kwon, Ho Geol Ryu, Hannah Lee, Yongjae Yoo
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Korean J Crit Care Med. 2013;28(1):59-63.
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DOI: https://doi.org/10.4266/kjccm.2013.28.1.59
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Abstract
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- Upper extremity deep vein thrombosis (UEDVT) is relatively uncommon and superior vena cava (SVC) filter placements are not often encountered due to strict indication. A 33-year old male with underlying protein C/S deficiency and secondary liver cirrhosis was admitted because of hematemesis. The patient was conservatively managed, but underwent elective splenectomy to prevent aggravation of gastric varix. During postoperative care, the patient underwent cholecystectomy for acalculous cholecystitis.
During the postoperative course, UEDVT was detected and heparinization was initiated. The patient experienced repeated attacks of severe dyspnea, which was accompanied by chest pain that lasted for 3 to 10 minutes. Repeated episodes of pulmonary thromboembolism were suspected and SVC filter was placed. Warfarin treatment was initiated and the SVC filter was removed about one month later. The case highlights the clinical significance of UEDVT and reports rare case of SVC filter placement. Intensivists should have comprehensive understanding of UEDVT and its management.
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