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Korean J Crit Care Med > Volume 28(4); 2013 > Article
Korean Journal of Critical Care Medicine 2013;28(4): 327-330. doi: https://doi.org/10.4266/kjccm.2013.28.4.327
폐엽절제술 후 유미흉으로 치료를 받고 있던 환자에서 발생한 유미심막증에 의한 심장압전
Chylopericardial Tamponade in a Patient with Chylothorax after Pulmonary Lobectomy
Jin Sue Jeon, Ho Geol Ryu, Hannah Lee, Da Hye Yoo
1Department of Neurosurgery, Seoul University Hospital, Seoul University College of Medicine, Seoul, Korea.
2Department of Anesthesiology and Pain Medicine, Seoul University Hospital, Seoul University College of Medicine, Seoul, Korea. hogeol@gmail.com
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.
Key Words: chylopericardium; chylothorax; cardiac tamponade
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