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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
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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

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Footnotes

*

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

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