Reconstruction of occluded thoracic duct for treatment of chylopericardium: a novel surgical therapy

Journal of Vascular Surgery
Rowlens M MelduniPeter Gloviczki

Abstract

Chylopericardium is an uncommon disease predominantly caused by trauma. Prolonged chyle depletion may result in nutritional, metabolic, and immunologic deficiencies due to loss of essential proteins, immunoglobulins, fat, vitamins, electrolytes, and water. Medical treatment includes a low-fat diet with medium-chain triglyceride restriction, cardiac support, diuretic medications, and drainage of the pericardial effusion. Conventional surgical therapy consists of pericardial fenestration and thoracic duct ligation. We report a case of massive secondary chylous pericardial effusion successfully treated with microsurgical lymphovenous anastomosis, reconnecting the occluded thoracic duct to the internal jugular vein. This case highlights features and management strategies of this perplexing clinical condition.

References

Jan 1, 1985·The Annals of Thoracic Surgery·C L Robinson
Oct 1, 1996·The Journal of Thoracic and Cardiovascular Surgery·M FurrerH B Ris
Nov 1, 1996·The Journal of Thoracic and Cardiovascular Surgery·R J CerfolioP C Pairolero
Feb 1, 1997·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·R SvedjeholmC Olin
Jun 13, 2006·Journal of Vascular Surgery·Peter Gloviczki

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Citations

Jun 1, 2010·Mayo Clinic Proceedings·Masud H KhandakerJae K Oh
Dec 3, 2014·International Journal of Surgery Case Reports·John D DortchJohn D Casler
Mar 23, 2012·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Imad F TabryEugene M Constantini
Jan 30, 2018·Experimental and Therapeutic Medicine·Xue YuDeping Liu

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