Department of Pediatrics, Korea University College of Medicine and Korea University Medical Center, Seoul, South Korea.
Department of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea.
Cardiol Young. 2020 Apr;30(4):571-573. doi: 10.1017/S1047951120000323. Epub 2020 Feb 24.
A 29-month-old girl had idiopathic massive pericardial effusion for over 6 months. Lymphangiography was performed for chronic and recurrent pericardial effusion and pulmonary lymphangiectasia, suspected based on CT findings. Magnetic resonance lymphangiography revealed chylolymphatic reflux from a tortuously dilated thoracic duct in the mediastinum to the pericardial space, suggesting primary chylopericardium with lymphangiectasia. Pericardial effusion resolved immediately after thoracic duct embolisation at the lower thoracic level. However, pericardial effusion recurred after 5 months, which resolved after additional embolisation of the abnormal lymphatic collateral vessels from the remnant upper thoracic duct. Here, we report an unusual case with chylous massive pericardial effusion diagnosed by magnetic resonance lymphangiography and treated with percutaneous embolisation.
一名 29 月龄女孩患有特发性大量心包积液超过 6 个月。根据 CT 结果，怀疑存在慢性复发性心包积液和肺淋巴管扩张，因此进行了淋巴管造影术。磁共振淋巴造影显示，来自纵隔中迂曲扩张的胸导管的乳糜淋巴反流至心包腔，提示存在乳糜性心包积液伴淋巴管扩张。在胸导管低位栓塞后，心包积液立即得到缓解。然而，5 个月后心包积液再次复发，通过栓塞残留的上胸导管异常淋巴侧支血管后得到缓解。在此，我们报告了一例罕见的乳糜性大量心包积液病例，该病例通过磁共振淋巴造影诊断，并通过经皮栓塞治疗。
