Abstract
Chylotamponade involves rapid accumulation of chyle in the pericardium elevating the pericardial pressures above normal right heart filling pressures, and is extremely rare. A 12-y-old boy presented to the emergency with complaints of facial puffiness for 1 mo and breathing difficulty for 1 wk. The neck veins were distended, and the heart sounds were muffled. A chest CT demonstrated a large anterior mediastinal mass with pleural and pericardial effusions. Echocardiography confirmed cardiac tamponade. Pericardiocentesis revealed chylopericardium. He was placed on a chyle leak diet, and the drain was removed after 48 h. Biopsy of the mediastinal mass revealed a primary mediastinal B-cell lymphoma. He was successfully managed with chemotherapy. The index case demonstrates how prompt identification and management of chylotamponade and treatment of the underlying cause can lead to good clinical outcomes.
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All authors equally contributed to the preparation of the manuscript and approved its final version. KMK is the guarantor for the study.
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The study was conducted in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its amendments. Approval wavier was taken from the Institute Ethics Committee of Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram as this included data from a single patient only.
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Video 1 Transthoracic echocardiography from the apical 4-chamber view showing massive pericardial effusion (yellow asterisk), left pleural effusion (red asterisk) and collapsed left lung. The diastolic right atrial collapse and right ventricular collapse are evident (yellow arrows) classical of cardiac tamponade LA Left atrium; LL Left lung; LV Left ventricle; RA Right atrium, RV Right ventricle (MP4 18353 KB)
Video 2 Transthoracic echocardiography from the parasternal long axis view showing massive pericardial effusion (yellow asterisk) with swinging heart and right ventricular diastolic collapse (yellow arrow) and left pleural effusion (red asterisk)LA Left atrium; LV Left ventricle; RA Right atrium, RV Right ventricle (MP4 12840 KB)
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Sambaturu, V.K., Kurup, H.K.N., Gopalakrishnan, A. et al. Chylotamponade in Pediatric Primary Mediastinal Large B-Cell Lymphoma. Indian J Pediatr 89, 597–599 (2022). https://doi.org/10.1007/s12098-021-03986-0
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DOI: https://doi.org/10.1007/s12098-021-03986-0