2022 Volume 38 Issue 1 Pages 60-65
We report a case of idiopathic chylopericardium diagnosed by lymphangiography using lipiodol during treatment of bacterial meningitis. A previously healthy 8-year-old boy developed bacterial meningitis at the age of 6 years 3 months, and echocardiography revealed pericardial effusion. He had a history of recurrent bacterial meningitis at 6 years and 7 months and 7 years and 9 months of age. The pericardial fluid volume often fluctuated during these episodes. Based on evaluation of the pericardial drainage fluid, he was diagnosed with chylopericardium prior to this admission. The patient was referred to our hospital to undergo lymphangiography (using lipiodol) to localize the leakage site(s). We performed echography guided percutaneous puncture of his right-sided inguinal lymph nodes, and lipiodol was injected. We observed leakage from the thoracic duct into the pericardial sac at the tracheal bifurcation level. Lymphangiography via the inguinal lymph nodes is a less invasive and useful approach that is increasingly being reported for direct imaging in children.
