A Case of Chylopericardium Caused by Chylous Pleural Effusion Inflow from a Damaged Pericardium during Operation for Right Lung Cancer

Abstract

A 60-year-old woman had thoracoscopic right upper lobectomy with mediastinal lymph node dissection (ND2a-1) for primary cancer of the right upper lobe of lung (cT1cN0M0 Stage IA3) and was discharged from our hospital on postoperative day 4. However, she was emergently brought into our hospital on postoperative day 12 due to right chest pain with decreased blood pressure. Transthoracic echocardiography revealed a large amount of pericardial effusion. She was diagnosed with cardiac tamponade, and a pericardiocentesis was performed. The aspirated fluid showed features of chyle. She was diagnosed with chylopericardium and was discharged on 23^rd postoperative day. She was readmitted on 37^th postoperative day and was discharged on 54^th postoperative day. In our case, conservative treatments including pericardiocentesis and dietary measures were successful. Even though chylopericardium following lung cancer surgery is an extremely rare complication, it can lead to other life-threatening complications like cardiac tamponade. Therefore, we suggest that the possibility of this complication after lung cancer surgery should be considered.