The Annals of Thoracic Surgery, Vol 58, 262-266, Copyright © 1994 by The Society of Thoracic Surgeons
Primary chylopericardium
H Akamatsu, J Amano, T Sakamoto and A Suzuki
Department of Cardiothoracic Surgery, National Tokyo Medical and Dental University, School of Medicine, Japan.
To evaluate the surgical treatment of primary chylopericardium, 2 cases of
primary chylopericardium are described and previous case reports are
reviewed. Enhanced computed tomography combined with lymphangiography is a
very reliable diagnostic tool for identifying abnormalities of the thoracic
duct and its lymphatic channels connecting to the pericardium. When the
course of the thoracic duct was identified exactly, ligation and resection
of the thoracic duct with establishment of a pericardial window proved to
be the most effective surgical procedure. Because the thoracic duct and the
pericardium can be exposed easily, left thoracotomy seems to be the most
preferable approach for the operation.