We present a case of chylopericardium presenting as cardiac tamponade after a median sternotomy for mechanical aortic valve replacement. [ncbi.nlm.nih.gov]

• Mediastinal Lymphadenopathy

  A chest CT scan taken after pericardial window did not reveal mediastinal neoplasm, mediastinal lymphadenopathy or other abnormalities that might have obstructed the thoracic duct. The patient started a normal diet on a routine schedule. [cardiothoracicsurgery.biomedcentral.com]

  Chest x-ray showed an enlarged cardio-mediastinal shadow, while chest CT detected a 5 mm-right upper lobe pulmonary nodule, diffuse mediastinal lymphadenopathy and the presence of a 20 mm-circumferential pericardial effusion. [oatext.com]

  A chest CT scan did not reveal mediastinal neoplasm, mediastinal lymphadenopathy or other abnormalities that might have obstructed the thoracic duct. Lymphoscintigraphy was performed in all patients. [link.springer.com]

• Axillary Lymphadenopathy

  She was also having bilateral axillary lymphadenopathy (1 Χ 1 cm firm, mobile, non- tender and not fixed to underlying structures). Respiratory examination revealed grossly decreased movements bilaterally with stony dull percussion note. [lungindia.com]

• Overeating

  OBJECTIVES: We present a systematic overview of the literature on reported cases of chylous pericardial effusion in adults over the past 10 years, assessing clinical presentation, etiology, diagnosis, and treatment. [ncbi.nlm.nih.gov]

  Case 1 The fluid reaccumulated over a period of 2 months following which surgical option was sought. Under general anesthesia, left thoracoscopy was done using three 5-mm ports. [jiaps.com]

  Chylopericardium in adults: a literature review over the past decade (1996–2006). J Thorac Cardiovasc Surg 2008 ; 136: 650 – 656. Google Scholar Crossref Medline ISI 6. Chan, BB, Murphy, MC, Rodgers, BM. Management of chylopericardium. [journals.sagepub.com]

  The chyle leak continued to diminish in volume over the next five days, without any drainage by day eight. [cardiothoracicsurgery.biomedcentral.com]

  J Surg Case Rep 2017 ; 2017 : 1 – 2. 2 Chylopericardium in adults: a literature review over the past decade (1996-2006). J Thorac Cardiovasc Surg 2008 ; 136 : 650. 3 Primary idiopathic chylopericardium: a retrospective case series. [academic.oup.com]

• Papule

  During the fourth postoperative week, the patient complained of generalized itching with the appearance of diffuse papules. [oatext.com]

• Hydrops Fetalis

  Included also in this review was an 11-day old preterm infant with hydrops fetalis and congenital heart disease who developed chylothorax. [ncbi.nlm.nih.gov]

• Facial Edema

  edema one month after the patch closure for atrial septal defect. [e-sciencecentral.org]

• Suggestibility

  Lymphedema seems to suggest the existence of chylous reflux with pulmonary lymphangiectasis. The patient underwent pericardial fenestration and resection of the thoracic duct. [ncbi.nlm.nih.gov]

  After patent blue dye infusion into peripheral soft tissues, the appearance of coloring material in the effusion at 4 hours suggested direct communication of the pericardium with an apparently large thoracic duct. [journals.uair.arizona.edu]

  Echocardiogram was suggestive of mild constriction and cardiac MRI revealed a large pericardial effusion but no pericardial thickening (Figure 1D-E). Right and left heart catheterization were normal. [onlinejacc.org]

Workup revealed a moderately-sized pericardial effusion and multifocal infiltrates on CT (Figure 1B-C). Infectious and autoimmune workup were negative with only an elevated triglyceride level to 436. [onlinejacc.org]

The laboratory workup revealed hemoglobin 18 g/dL, leukocytes 6.4, glucose 73 mg/dL, creatinine 1.1 mg/dL, and C-reactive protein 62.2 mg/dL. The echocardiogram showed severe pericardial effusion. [revespcardiol.org]

[…] histological features of lung specimens from nine patients in whom no extrathoracic lesions were identified, which they termed "diffuse pulmonary lymphangiomatosis" (DPL). [4] Recognition of the disease requires a high index of suspicion and an extensive workup [en.wikipedia.org]

• Pericardial Effusion

  Echocardiography revealed a large pericardial effusion. A specific diagnosis of chylopericardium was made by pericardiocentesis and analysis of the fluid. [ncbi.nlm.nih.gov]

• Right Pleural Effusion

  Postoperative chest CT: massive right pleural effusion with mediastinal shift. [oatext.com]

• Flattened T Wave

  On electrocardiography, non-specific flattening T-waves are present; while, echocardiography demonstrates the presence of pericardial effusion. [oatext.com]

• Foam Cell

  In cholesterol pericarditis the fluid contains cholesterol crystals, foam cells, macrophages and giant cells. The fluid in cholesterol pericarditis is clear, and classically is said to have a glittering "gold paint" appearance. [wikidoc.org]

The clinical findings and treatment performed are discussed. [ncbi.nlm.nih.gov]

Differentiation of Chylopericardium from other Disorders Cholesterol pericarditis Natural History, Complications, Prognosis Infection, tamponade, or constriction may aggravate the prognosis. [wikidoc.org]

[…] than does multi-organ involvement; the combination of pleural and peritoneal involvement with chylous effusions and lytic bone lesions carries the least favorable prognosis. [16] When lung involvement is suspected, high resolution computed tomography [en.wikipedia.org]

The most likely etiology of benign obstruction of the superior vena cava (SVC) include fibrosing mediastinitis and iatrogenic etiologies such as sclerosis and obstruction caused by pacemakers and central venous catheter. [ncbi.nlm.nih.gov]

Epidemiology [ edit ] Lymphangiomatosis can occur at any age, but the incidence is highest in children and teenagers. [en.wikipedia.org]

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. [ncbi.nlm.nih.gov]

This highly acclaimed text offers ICU clinicians a new understanding of the pathophysiology of critical illness and new therapeutic approaches to critical care. [books.google.com]

The pathophysiology of isolated postoperative chylopericardium is still uncertain. [e-sciencecentral.org]

Explaining the pathophysiology of primary chylopericardium is not simple. [revespcardiol.org]

Chyle comes from the lacteals (the lymphatics draining the small intestine ) via the thoracic duct. [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12]. [13] [14] [15] [16] [17] [18] [19] [20] [21] [22] [23] Pathophysiology Chylopericardium is most often [wikidoc.org]

The inflammatory process may have caused fibrin production and tissue adhesion in the pericardial cavity, and these might have prevented an accumulation of chyloid fluid and occluded the connection between the thoracic duct and the pericardial cavity. [ncbi.nlm.nih.gov]

The patient should be evaluated rapidly to prevent the complications of this disease. [link.springer.com]

Thoracic duct ligation and pericardial window formation are believed to be the most effective procedures to prevent recurrence. [7], [9] In our experience, we tried pericardial window formation in both patients; however, first patient showed resolution [jiaps.com]

However, this strategy presents high failure rates up to 60% and therefore, in the absence of an early improvement ( Pericardiectomy is effective in preventing recurrences, but post-operative myocardial hernias are life-threating complications. [oatext.com]