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Chylopericardium

MedGen UID:
69184
•Concept ID:
C0242426
•
Disease or Syndrome
Synonym: Chylopericardiums
SNOMED CT: Chylopericardium (233890005)
 
HPO: HP:0011852

Definition

Accumulation of chyle (the whitish fluid taken up by the lacteals in the intestine, consisting of an emulsion of lymph and triglyceride fat thatpasses into the veins by the thoracic duct) in the pericardium. Chylopericardium is generally caused by obstruction of or trauma to the thoracic duct. [from HPO]

Professional guidelines

PubMed

Nontraumatic Chylothorax and Chylopericardium: Diagnosis and Treatment Using an Algorithmic Approach Based on Novel Lymphatic Imaging.
Gurevich A, Hur S, Singhal S, DiBardino D, Haas AR, Hansen-Flaschen JH, Nadolski G, Itkin M
Ann Am Thorac Soc 2022 May;19(5):756-762. doi: 10.1513/AnnalsATS.202103-262OC. PMID: 34797746
Interventional Treatment of Pulmonary Lymphatic Anomalies.
Itkin M
Tech Vasc Interv Radiol 2016 Dec;19(4):299-304. Epub 2016 Oct 8 doi: 10.1053/j.tvir.2016.10.005. PMID: 27993326
Evolution of chylous fistula management after neck dissection.
Campisi CC, Boccardo F, Piazza C, Campisi C
Curr Opin Otolaryngol Head Neck Surg 2013 Apr;21(2):150-6. doi: 10.1097/MOO.0b013e32835e9d97. PMID: 23449286

Recent clinical studies

Etiology

Nontraumatic Chylothorax and Chylopericardium: Diagnosis and Treatment Using an Algorithmic Approach Based on Novel Lymphatic Imaging.
Gurevich A, Hur S, Singhal S, DiBardino D, Haas AR, Hansen-Flaschen JH, Nadolski G, Itkin M
Ann Am Thorac Soc 2022 May;19(5):756-762. doi: 10.1513/AnnalsATS.202103-262OC. PMID: 34797746
Interventional Treatment of Pulmonary Lymphatic Anomalies.
Itkin M
Tech Vasc Interv Radiol 2016 Dec;19(4):299-304. Epub 2016 Oct 8 doi: 10.1053/j.tvir.2016.10.005. PMID: 27993326
Chylopericardium in adults: a literature review over the past decade (1996-2006).
Dib C, Tajik AJ, Park S, Kheir ME, Khandieria B, Mookadam F
J Thorac Cardiovasc Surg 2008 Sep;136(3):650-6. Epub 2008 Jun 2 doi: 10.1016/j.jtcvs.2008.03.033. PMID: 18805268
Isolated chylopericardium after intrapericardial procedures: possible role of inadvertent right efferent lymphatic trunk injury.
Kan CD, Wang JN, Wu JM, Yang YJ
Tex Heart Inst J 2007;34(1):82-7. PMID: 17420799Free PMC Article
Congenital Heart Surgery Nomenclature and Database Project: diseases of the pericardium.
Mehta SM, Myers JL
Ann Thorac Surg 2000 Apr;69(4 Suppl):S191-6. doi: 10.1016/s0003-4975(99)01244-8. PMID: 10798429

Diagnosis

Dynamic contrast-enhanced magnetic resonance lymphangiography.
Ramirez-Suarez KI, Tierradentro-Garcia LO, Smith CL, Krishnamurthy G, Escobar FA, Otero HJ, Rapp JB, Dori Y, Biko DM
Pediatr Radiol 2022 Feb;52(2):285-294. Epub 2021 Apr 8 doi: 10.1007/s00247-021-05051-6. PMID: 33830292
Post-cardiac Surgery Chylopericardium.
Yuan SM
J Coll Physicians Surg Pak 2020 Jun;30(6):627-632. doi: 10.29271/jcpsp.2020.06.627. PMID: 32703349
Interventional Treatment of Pulmonary Lymphatic Anomalies.
Itkin M
Tech Vasc Interv Radiol 2016 Dec;19(4):299-304. Epub 2016 Oct 8 doi: 10.1053/j.tvir.2016.10.005. PMID: 27993326
Primary chylopericardium.
Akamatsu H, Amano J, Sakamoto T, Suzuki A
Ann Thorac Surg 1994 Jul;58(1):262-6. doi: 10.1016/0003-4975(94)91124-x. PMID: 8037546
Chylopericardium and chylothorax.
Crosby IK, Crouch J, Reed WA
J Thorac Cardiovasc Surg 1973 Jun;65(6):935-9. PMID: 4704244

Therapy

Post-medistinoscopy chylopericardium.
Abbas S, Purohit M, Cassidy C
Interact Cardiovasc Thorac Surg 2022 Jun 1;34(6):1165-1167. doi: 10.1093/icvts/ivab365. PMID: 34964452Free PMC Article
Post-cardiac Surgery Chylopericardium.
Yuan SM
J Coll Physicians Surg Pak 2020 Jun;30(6):627-632. doi: 10.29271/jcpsp.2020.06.627. PMID: 32703349
Interventional Treatment of Pulmonary Lymphatic Anomalies.
Itkin M
Tech Vasc Interv Radiol 2016 Dec;19(4):299-304. Epub 2016 Oct 8 doi: 10.1053/j.tvir.2016.10.005. PMID: 27993326
Chylothorax and chylopericardium in Behçet's diseases: case report and literature review.
Zhang L, Zu N, Lin B, Wang G
Clin Rheumatol 2013 Jul;32(7):1107-11. Epub 2013 Apr 16 doi: 10.1007/s10067-013-2248-9. PMID: 23588879
Evolution of chylous fistula management after neck dissection.
Campisi CC, Boccardo F, Piazza C, Campisi C
Curr Opin Otolaryngol Head Neck Surg 2013 Apr;21(2):150-6. doi: 10.1097/MOO.0b013e32835e9d97. PMID: 23449286

Prognosis

Interventional Treatment of Pulmonary Lymphatic Anomalies.
Itkin M
Tech Vasc Interv Radiol 2016 Dec;19(4):299-304. Epub 2016 Oct 8 doi: 10.1053/j.tvir.2016.10.005. PMID: 27993326
Chylopericardium presenting with tamponade and cardiogenic shock.
Novitzky D, Guglin M
J Card Surg 2010 Sep;25(5):522-4. doi: 10.1111/j.1540-8191.2010.01047.x. PMID: 20487105
Chylopericardium in adults: a literature review over the past decade (1996-2006).
Dib C, Tajik AJ, Park S, Kheir ME, Khandieria B, Mookadam F
J Thorac Cardiovasc Surg 2008 Sep;136(3):650-6. Epub 2008 Jun 2 doi: 10.1016/j.jtcvs.2008.03.033. PMID: 18805268
Chylopericardium after cardiac operations in children.
Campbell RM, Benson LN, Williams WW, Adatia I
Ann Thorac Surg 2001 Jul;72(1):193-6. doi: 10.1016/s0003-4975(01)02614-5. PMID: 11465177
Primary chylopericardium.
Akamatsu H, Amano J, Sakamoto T, Suzuki A
Ann Thorac Surg 1994 Jul;58(1):262-6. doi: 10.1016/0003-4975(94)91124-x. PMID: 8037546

Clinical prediction guides

Computed tomography values of pericardial effusion may predict chylopericardium: a case report.
Nakata M, Yokota N, Kenzaka T
BMC Cardiovasc Disord 2023 Feb 10;23(1):79. doi: 10.1186/s12872-023-03112-2. PMID: 36765291Free PMC Article
Interventional Treatment of Pulmonary Lymphatic Anomalies.
Itkin M
Tech Vasc Interv Radiol 2016 Dec;19(4):299-304. Epub 2016 Oct 8 doi: 10.1053/j.tvir.2016.10.005. PMID: 27993326
Thoracic duct embolization for nontraumatic chylous effusion: experience in 34 patients.
Nadolski GJ, Itkin M
Chest 2013 Jan;143(1):158-163. doi: 10.1378/chest.12-0526. PMID: 22797603
Chylopericardium in adults: a literature review over the past decade (1996-2006).
Dib C, Tajik AJ, Park S, Kheir ME, Khandieria B, Mookadam F
J Thorac Cardiovasc Surg 2008 Sep;136(3):650-6. Epub 2008 Jun 2 doi: 10.1016/j.jtcvs.2008.03.033. PMID: 18805268
Chylothorax and chylopericardium as the initial clinical manifestation of Behcet's disease.
Moon H, Lee YJ, Lee SI, Yoo WH
Rheumatol Int 2008 Feb;28(4):375-7. Epub 2007 Aug 3 doi: 10.1007/s00296-007-0426-2. PMID: 17674002

Recent systematic reviews

Clinical characteristics, evaluation and outcomes of chylopericardium: a systematic review.
Verma B, Kumar A, Verma N, Agrawal A, Yesilyaprak A, Furqan MM, Mahalwar G, Berglund F, Manna S, Schleicher M, Raeisi-Giglou P, Nasser M, Jabri A, Wang TKM, Klein AL
Heart 2023 Aug 11;109(17):1281-1285. doi: 10.1136/heartjnl-2022-321798. PMID: 36702544Free PMC Article
Post-cardiac Surgery Chylopericardium.
Yuan SM
J Coll Physicians Surg Pak 2020 Jun;30(6):627-632. doi: 10.29271/jcpsp.2020.06.627. PMID: 32703349

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