title: Primary idiopathic chylopericardium: a retrospective case series.
abstract: BACKGROUND
  Primary idiopathic chylopericardium is a rare clinical entity characterized by the accumulation of chyle within the pericardial cavity without a definitive cause. The aim of this study was to assess the clinical presentation, etiology, diagnosis, treatment and follow-up of primary idiopathic chylopericardium.
  
  
  METHODS
  We retrospectively reviewed 9 cases of patients who suffered from primary idiopathic chylopericardium at our hospital from January 1993 to November 2013.
  
  
  RESULTS
  There were two males and seven females among our patients. Their ages ranged from 13 to 55 years. The most common clinical presentation was dyspnea. The etiology was idiopathic. All patients were diagnosed by pericardiocentesis, computed tomography of the chest and lymphoscintigraphy. Non-surgical therapy was adopted in all nine patients and failed in six, who underwent subsequent successful surgery. Thoracic duct ligation with the creation of a pericardial window was the most common surgical procedure. All patients were followed up from 3 months to 9 years, and no recurrence occurred.
  
  
  CONCLUSIONS
  In assessing patients with an enlarged cardiac silhouette, one should be aware of primary idiopathic chylopericardium. The most effective treatment is ligation of the thoracic duct and the creation of a pericardial window.
authors.affiliation: Department of Thoracic Surgery, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), 1 Shuai-Fu-Yuan, Beijing, 100730, China.
authors.forename: Zhijun
authors.initials: Z
authors.lastname: Han
authors.affiliation: Department of Thoracic Surgery, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), 1 Shuai-Fu-Yuan, Beijing, 100730, China.
authors.forename: Shanqing
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of nuclear medicine, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), 1 Shuai-Fu-Yuan, Beijing, 100730, China.
authors.forename: Hongli
authors.initials: H
authors.lastname: Jing
authors.affiliation: Department of Thoracic Surgery, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), 1 Shuai-Fu-Yuan, Beijing, 100730, China. victorm@163.com.
authors.forename: Hongsheng
authors.initials: H
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D004035:Diet Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D020519:Pericardiocentesis; D012189:Retrospective Studies; D019616:Thoracic Surgical Procedures; D016896:Treatment Outcome