Chylopericardium following esophagectomy: a case report and systematic review.
J Cardiothorac Surg
; 19(1): 50, 2024 Feb 03.
Article
in En
| MEDLINE
| ID: mdl-38310296
ABSTRACT
BACKGROUND:
Chylopericardium is a rare condition characterized by the accumulation of chyle in the pericardial space. It is most commonly caused by thoracic duct injury. Chylopericardium following esophagectomy is extremely rare but can cause life-threatening complications. This report presents a case of chylopericardium post-esophagectomy, resulting in cardiac tamponade and cardiac arrest. A systematic literature review was also conducted to facilitate the understanding of this rare condition. CASE PRESENTATION A 41-year-old male was admitted to our hospital with intermediate to highly differentiated squamous cell carcinoma of the mid-thoracic esophagus (clinical T4NxM0). He underwent thoracoscopic-laparoscopic esophagectomy with cervical anastomosis. On postoperative day 1, patient had a cardiac arrest secondary to cardiac tamponade, requiring emergency ultrasound-guided drainage. The drained fluid was initially serous but became chylous after the administration of enteral nutritional emulsion. As a result of significant daily pericardial drainage, patient subsequently underwent thoracic duct ligation. The amount of drainage was substantially reduced post-thoracic duct ligation. Over a period of 2 years and 7 months, patient recovered well and tolerated full oral diet. A comprehensive literature review was conducted and 4 reported cases were identified. Among these cases, three patients developed pericardial tamponade secondary to chylopericardium post-esophagectomy.CONCLUSION:
Chylopericardium is a rare but serious complication post-esophagectomy. Prompt echocardiography and thorough pericardial fluid analysis are crucial for diagnosis. Thoracic duct ligation has been shown to be an effective management approach for this condition.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pericardial Effusion
/
Cardiac Tamponade
/
Heart Arrest
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Systematic_reviews
Limits:
Adult
/
Humans
/
Male
Language:
En
Journal:
J Cardiothorac Surg
Year:
2024
Document type:
Article
Affiliation country: