Abstract
Primary idiopathic chylopericardium is an extremely rare condition especially in children and young adults. Although the exact pathophysiology of primary chylopericardium has not been established, the reflux of chylous fluid into the pericardial space was suggested as the etiology. Damage to the thoracic duct valves and the communication of the thoracic duct to the pericardial lymphatics or abnormally elevated pressure in the thoracic duct could cause chylous fluid reflux. In this report, we described the case of a 4-year-old boy with primary idiopathic chylopericardium presenting as cardiac tamponade who was treated with video-assisted thoracoscopic window and then surgical duct ligation.
Zusammenfassung
Ein primäres idiopathisches Chyloperikard ist eine äußerst seltene Erkrankung, insbesondere bei Kindern und jungen Erwachsenen. Obwohl die genaue Pathophysiologie des primären Chyloperikards bisher nicht bekannt ist, soll der Reflux chylöser Flüssigkeit in den perikardialen Raum ätiologisch relevant sein. Eine Schädigung der Klappen des Ductus thoracicus und eine Verbindung des Ductus thoracicus mit den perikardialen Lymphwegen oder abnorm erhöhter Druck im Ductus thoracicus könnten einen Reflux chylöser Flüssigkeit verursachen. Im vorliegenden Artikel wird der Fall eines 4-jährigen Jungen beschrieben, bei dem ein primäres idiopathisches Chyloperikard, das sich als Herzbeuteltamponade manifestierte, vorlag und die Behandlung über eine videoassistierte thorakoskopische Fensterung mit anschließender chirurgischer Duktusligatur erfolgte.
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On behalf of all authors, the corresponding author states that there are no conflicts of interest.
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Additional material onlineThis article includes two additional Videos. You will find this supplemental at dx.doi.org/10.1007/s00059-013-3875-2.
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59_2013_3875_MO1_ESM.avi
Video 1. Echocardiographic examination after pericardiocentesis shows pericardial effusion maximally measured as 26 mm (AVI 4MB)
Video 2. Opening of pericardial window (MP4 84MB)
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Karakurt, C., Çelik, S., Çelik, R. et al. Primary idiopathic chylopericardium presenting with cardiac tamponade. Herz 39, 644–646 (2014). https://doi.org/10.1007/s00059-013-3875-2
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DOI: https://doi.org/10.1007/s00059-013-3875-2