Chylopericardium following esophagectomy: a case report and systematic review
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 prese...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-024-02536-x |
| _version_ | 1827326220249858048 |
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| author | Xinglin Yang Jinghong Zhang Pengxia Sun Jihai Liu Jiangshan Wang Huadong Zhu |
| author_facet | Xinglin Yang Jinghong Zhang Pengxia Sun Jihai Liu Jiangshan Wang Huadong Zhu |
| author_sort | Xinglin Yang |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-07T14:41:25Z |
| format | Article |
| id | doaj.art-174c0814255b499fa59074ae52569966 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-03-07T14:41:25Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-174c0814255b499fa59074ae525699662024-03-05T20:18:26ZengBMCJournal of Cardiothoracic Surgery1749-80902024-02-011911610.1186/s13019-024-02536-xChylopericardium following esophagectomy: a case report and systematic reviewXinglin Yang0Jinghong Zhang1Pengxia Sun2Jihai Liu3Jiangshan Wang4Huadong Zhu5Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeCentral Clinical School, Monash UniversityEmergency Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeEmergency Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeEmergency Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeEmergency Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeAbstract 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.https://doi.org/10.1186/s13019-024-02536-xChylopericardiumEsophagectomyCardiac tamponadeThoracic ductCase report |
| spellingShingle | Xinglin Yang Jinghong Zhang Pengxia Sun Jihai Liu Jiangshan Wang Huadong Zhu Chylopericardium following esophagectomy: a case report and systematic review Journal of Cardiothoracic Surgery Chylopericardium Esophagectomy Cardiac tamponade Thoracic duct Case report |
| title | Chylopericardium following esophagectomy: a case report and systematic review |
| title_full | Chylopericardium following esophagectomy: a case report and systematic review |
| title_fullStr | Chylopericardium following esophagectomy: a case report and systematic review |
| title_full_unstemmed | Chylopericardium following esophagectomy: a case report and systematic review |
| title_short | Chylopericardium following esophagectomy: a case report and systematic review |
| title_sort | chylopericardium following esophagectomy a case report and systematic review |
| topic | Chylopericardium Esophagectomy Cardiac tamponade Thoracic duct Case report |
| url | https://doi.org/10.1186/s13019-024-02536-x |
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