Idiopathic primary chylopericardium with associated chylothorax following coronary artery surgery--successful conservative treatment.
A 58-year-old Asian male underwent an uneventful triple coronary bypass that included a pedicled left internal mammary artery (LIMA) graft. On the third postoperative day, following resumption of full oral intake he developed a high output left-sided chylothorax. Initial therapy with a medium chain trigylceride diet and intercostal drainage showed no improvement. CT scan demonstrated a chylopericardium that was drained percutaneously. Complete resolution occurred 2 weeks later with adequate drainage and institution of total parenteral nutrition avoiding further surgery. We discuss the etiology and management of this rare complication following coronary surgery.
Sachithanandan
Anand
A
Department of Cardio thoracic Surgery, University Hospital Birmingham NHS Trust, Queen Elizabeth Hospital, Birmingham B15 2TH, United Kingdom.
Nanjaiah
Prakash
P
Rooney
Stephen J
SJ
Rajesh
Pala B
PB
D002916:Chylothorax / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004322:Drainage; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D014057:Tomography, X-Ray Computed