A case of chylopericardium following operation for right lung cancer

Abstract

A 57-year-old man underwent thoracoscopic right lower lobectomy for primary lung cancer. Three months later, chest radiography showed an enlarged cardiac silhouette, and chest computed tomography showed a large pericardial effusion. Pericardiocentesis yielded 660 ml of milky fluid, confirming the diagnosis of chylopericardium. Lymphangiography revealed no injury to the thoracic duct. The patient was successfully treated with a thoracoscopic pericardial window. Chylopericardium following an operation for lung cancer is extremely rare. There are only 9 reported cases, including ours. Chylopericardium occurred after more than 20 days following right thoracotomy in 8 of the cases. Only one case occurred after left thoracotomy in the early postoperative period. We discuss and report this rare complication, along with a literature review.