Zhao ZePeng, Zhu Yu, Zhang Tao
Jining Medical University School of Clinical Medicine (Affiliated Hospital), Jining 272000, Shandong Province, China.
Thoracic Surgery Department, Jining Medical University Affiliated Hospital, Jining 272000, Shandong Province, China.
Int J Surg Case Rep. 2025 Aug;133:111663. doi: 10.1016/j.ijscr.2025.111663. Epub 2025 Jul 15.
Chylothorax is a rare but serious complication following thoracic surgery, characterized by the abnormal accumulation of chylous fluid within the pleural cavity or other intrathoracic spaces. Owing to its low incidence, chylothorax is often underrecognized by clinicians. Among its various forms, chylopericardium is even rarer and poses greater clinical challenges.
The patient was a 55-year-old woman who developed acute pericardial tamponade on postoperative day 7, presenting with sudden loss of consciousness and cardiorespiratory arrest. Pericardiocentesis revealed a large volume of chylous fluid. After 19 days in a coma, the patient gradually regained consciousness. On postoperative day 31, she underwent thoracoscopic low thoracic duct ligation and pericardial fenestration. Following the procedure, the volume of drainage decreased significantly, and she was subsequently discharged from the hospital.
Chylopericardium is a rare complication of esophageal cancer. It focuses on the causes of its occurrence and how to accurately diagnose and treat it.
The abnormal occurrence of this case provides key insights into diagnosis, resuscitation, etiology speculation, surgical intervention, and patient rehabilitation, forming a mutually verified comprehensive cycle, which provides important guidance for the management of similar diseases.
乳糜胸是胸外科手术后一种罕见但严重的并发症,其特征是乳糜液在胸腔或其他胸内间隙异常积聚。由于其发病率低,临床医生往往认识不足。在其各种形式中,乳糜心包更为罕见,且带来更大的临床挑战。
患者为一名55岁女性,术后第7天出现急性心包填塞,表现为突然意识丧失和心肺骤停。心包穿刺抽出大量乳糜液。昏迷19天后,患者逐渐恢复意识。术后第31天,她接受了胸腔镜下低位胸导管结扎和心包开窗术。术后,引流量显著减少,随后患者出院。
乳糜心包是食管癌的一种罕见并发症。重点讨论了其发生原因以及如何准确诊断和治疗。
该病例的异常情况为诊断、复苏、病因推测、手术干预和患者康复提供了关键见解,形成了相互验证的综合循环,为类似疾病的管理提供了重要指导。