Svedjeholm R, Jansson K, Olin C
Department of Cardiothoracic Surgery, Linköping Heart Center, University Hospital, Sweden.
Eur J Cardiothorac Surg. 1997 Feb;11(2):387-90. doi: 10.1016/s1010-7940(96)01040-8.
Primary idiopathic chylopericardium is a rare entity with obscure etiology. In recent years, a few reports have been published where the lymphatic leak and fistula were identified by combined lymphangiography and computed tomography or intraoperative thoracic ductogram. Here we report a case occurring in a previously healthy 51 year old woman, to our knowledge the first case described in Scandinavia. She presented with cough and dyspnea of about 1 year duration. Chest X-ray demonstrated enlargement of the cardiac silhouette. Echocardiography revealed pericardial effusion and at puncture pericardiocentecis 760 ml of chylous fluid was evacuated. There was no history of trauma, infection or neoplasm. She underwent extensive investigations but no apparent cause of the chylous effusion could be determined. Conservative treatment with pericardial drainage and low fat (medium chain triglyceride) diet failed. The patient was cured by surgical ligature of the thoracic duct and partial pericardectomy through a left anterolateral thoracotomy. At 12 months post operation she was doing well and echocardiography did not reveal any signs of recurrence. A brief review of the literature is presented.
原发性特发性乳糜性心包炎是一种病因不明的罕见病症。近年来，已有一些报告发表，其中通过淋巴管造影和计算机断层扫描或术中胸导管造影确定了淋巴漏和瘘管。在此，我们报告一例发生在一名51岁既往健康女性身上的病例，据我们所知，这是斯堪的纳维亚地区描述的首例病例。她出现咳嗽和呼吸困难约1年时间。胸部X线显示心影增大。超声心动图显示心包积液，心包穿刺抽出760毫升乳糜液。无外伤、感染或肿瘤病史。她接受了广泛检查，但未能确定乳糜性积液的明显病因。心包引流和低脂（中链甘油三酯）饮食的保守治疗失败。患者通过经左前外侧开胸手术结扎胸导管和部分心包切除术治愈。术后12个月，她情况良好，超声心动图未显示任何复发迹象。本文对相关文献进行了简要综述。
