Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-10T05:28:17.010Z Has data issue: false hasContentIssue false
  • English
  • Français

Successful thoracic duct embolisation in a child with recurrent massive pericardial effusion diagnosed as a lymphatic anomaly

Part of: Interventional Cardiology

Published online by Cambridge University Press:  24 February 2020

Jue Seong Lee Open the ORCID record for Jue Seong Lee [Opens in a new window] ,
Mi Kyoung Song  and
Saebeom Hur
Jue Seong Lee
Affiliation:
Department of Pediatrics, Korea University College of Medicine and Korea University Medical Center, Seoul, South Korea
Mi Kyoung Song*
Affiliation:
Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, South Korea
Saebeom Hur*
Affiliation:
Department of Radiology, Seoul National University Hospital, Seoul, South Korea
*
Authors for correspondence: M. K. Song, MD, Department of Pediatrics, Seoul National University Children’s Hospital, 101 Daehang-Ro, Jongno-gu, Seoul03080, South Korea. Tel: +82-2-2072-4193; Fax: +82-2-743-3455. E-mail: mksong52@gmail.com S. Hur, MD, Department of Radiology, Seoul National University Hospital, 101 Daehang-Ro, Jongno-gu, Seoul03080, South Korea. Tel: +82-2-2072-2584; Fax: +82-2-743-6385.E-mail: saebeom.hur@snu.ac.kr
Authors for correspondence: M. K. Song, MD, Department of Pediatrics, Seoul National University Children’s Hospital, 101 Daehang-Ro, Jongno-gu, Seoul03080, South Korea. Tel: +82-2-2072-4193; Fax: +82-2-743-3455. E-mail: mksong52@gmail.com S. Hur, MD, Department of Radiology, Seoul National University Hospital, 101 Daehang-Ro, Jongno-gu, Seoul03080, South Korea. Tel: +82-2-2072-2584; Fax: +82-2-743-6385.E-mail: saebeom.hur@snu.ac.kr
Get access Rights & Permissions [Opens in a new window]

Abstract

A 29-month-old girl had idiopathic massive pericardial effusion for over 6 months. Lymphangiography was performed for chronic and recurrent pericardial effusion and pulmonary lymphangiectasia, suspected based on CT findings. Magnetic resonance lymphangiography revealed chylolymphatic reflux from a tortuously dilated thoracic duct in the mediastinum to the pericardial space, suggesting primary chylopericardium with lymphangiectasia. Pericardial effusion resolved immediately after thoracic duct embolisation at the lower thoracic level. However, pericardial effusion recurred after 5 months, which resolved after additional embolisation of the abnormal lymphatic collateral vessels from the remnant upper thoracic duct. Here, we report an unusual case with chylous massive pericardial effusion diagnosed by magnetic resonance lymphangiography and treated with percutaneous embolisation.

Keywords

Pericardial effusionlymphatic anomalythoracic duct embolisation
Type
Brief Report
Information
Cardiology in the Young , Volume 30 , Issue 4 , April 2020 , pp. 571 - 573
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Mi Kyoung Song and Saebeom Hur have contributed equally as corresponding authors.

References

Wang, C-H, Hung, M-J, Cherng, W-J, Yen, T-C, Ng, K-K, Lee, C-M.Pedal 99mTc-sulfur colloid lymphoscintigraphy in primary isolated chylopericardium. Chest 2000; 117: 598–601.CrossRefGoogle Scholar
Krishnamurthy, R, Hernandez, A, Kavuk, S, Annam, A, Pimpalwar, S.Imaging the central conducting lymphatics: initial experience with dynamic MR lymphangiography. Radiology 2014; 274: 871–878.CrossRefGoogle ScholarPubMed
Itkin, M, Swe, NM, Shapiro, SE, Shrager, JB.Spontaneous chylopericardium: delineation of the underlying anatomic pathology by CT lymphangiography. Ann Thorac Surg 2009; 87: 1595–1597.CrossRefGoogle ScholarPubMed
Svedjeholm, R, Jansson, K, Olin, C.Primary idiopathic chylopericardium–a case report and review of the literature. Eur J Cardio-Thorac Surg Off J Eur Assoc Cardio-Thorac Surg 1997; 11: 387–390.CrossRefGoogle ScholarPubMed
Yu, X, Jia, N, Ye, S, Zhou, M, Liu, D.Primary chylopericardium: a case report and literature review. Exp Ther Med 2018; 15: 419–425. doi: 10.3892/etm.2017.5383.Google ScholarPubMed
Nadolski, GJ, Itkin, M.Thoracic duct embolization for nontraumatic chylous effusion: experience in 34 patients. Chest 2013; 143: 158–163.10.1378/chest.12-0526CrossRefGoogle ScholarPubMed
Cope, C, Kaiser, LR.Management of unremitting chylothorax by percutaneous embolization and blockage of retroperitoneal lymphatic vessels in 42 patients. JVasc Interventional Radiol 2002; 13: 1139–1148.CrossRefGoogle ScholarPubMed
Chen, E, Itkin, M. Thoracic Duct Embolization for Chylous Leaks. Semin intervent Radiol 2011; 28: 63–74. doi: 10.1055/s-0031-1273941.CrossRefGoogle Scholar
Laslett, D, Trerotola, SO, Itkin, M.Delayed complications following technically successful thoracic duct embolization. J Vasc Interventional Radiol 2012; 23: 76–79.10.1016/j.jvir.2011.10.008CrossRefGoogle ScholarPubMed