Advertisement

Pediatric Radiology

, Volume 45, Issue 6, pp 927–930 | Cite as

Idiopathic chylopericardium treated by percutaneous thoracic duct embolization after failed surgical thoracic duct ligation

  • Malachi Courtney
  • Raj R. AyyagariEmail author
Case Report

Abstract

Chylopericardium rarely occurs in pediatric patients, but when it does it is most often a result of lymphatic injury during cardiothoracic surgery. Primary idiopathic chylopericardium is especially rare, with few cases in the pediatric literature. We report a 10-year-old boy who presented with primary idiopathic chylopericardium after unsuccessful initial treatment with surgical lymphatic ligation and creation of a pericardial window. Following readmission to the hospital for a right-side chylothorax resulting from the effluent from the pericardial window, he had successful treatment by interventional radiology with percutaneous thoracic duct embolization. This case illustrates the utility of thoracic duct embolization as a less-invasive alternative to surgical thoracic duct ligation, or as a salvage procedure when surgical ligation fails.

Keywords

Chylopericardium Chylothorax Pericardial effusion Thoracic duct embolization Child Interventional radiology 

Notes

Conflicts of interest

None

References

  1. 1.
    Mask WK, Penido JR, Printup C (1990) Primary idiopathic chylopericardium. J Thorac Cardiovasc Surg 99:569–571PubMedGoogle Scholar
  2. 2.
    Bhat P, Ananthakrishna R, Panneerselvam A et al (2011) Recurrent chylopericardium. BMJ Case Rep. doi: 10.1136/bcr.07.2011.4520 Google Scholar
  3. 3.
    Hashim SA, Roholt HB, Babayan VK et al (1964) Treatment of chyluria and chylothorax with medium-chain triglyceride. N Engl J Med 270:756–761CrossRefPubMedGoogle Scholar
  4. 4.
    Lichter I, Hill GL, Nye ER (1968) The use of medium-chain triglycerides in the treatment of chylothorax in a child. Ann Thorac Surg 5:352–355CrossRefPubMedGoogle Scholar
  5. 5.
    Groves LK, Effler DB (1954) Primary chylopericardium. N Engl J Med 250:520–523CrossRefPubMedGoogle Scholar
  6. 6.
    Nath DS, Savla J, Khemani RG et al (2009) Thoracic duct ligation for persistent chylothorax after pediatric cardiothoracic surgery. Ann Thorac Surg 88:246–252CrossRefPubMedGoogle Scholar
  7. 7.
    Cope C (1998) Diagnosis and treatment of postoperative chyle leakage via percutaneous transabdominal catheterization of the cisterna chyli: a preliminary study. J Vasc Interv Radiol 9:727–734CrossRefPubMedGoogle Scholar
  8. 8.
    Chen E, Itkin M (2011) Thoracic duct embolization for chylous leak. Semin Intervent Radiol 28:63–74PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Yale New Haven HospitalYale School of MedicineNew HavenUSA
  2. 2.Department of RadiologyDivision of Interventional RadiologyNew HavenUSA

Personalised recommendations