Primary chylopericardium: a review of the literature and an illustrated case.

A report of a case of chylous pericardium and a review of previously reported cases are given. The specific diagnosis can be made with pericardiocentesis and analysis of the fluid which is milky in appearance and contains fat droplets microscopically. Thoracic duct obstruction with failure of adequate collateral drainage and resultant reflux of chylous lymph through lymphatics draining the heart and pericardium is proposed as a mechanism of development of this entity. Thoracic duct ligation and partial pericardectomy remain the preferred treatment for chylopericardium.