关键词: 心包渗漏, 特发性乳糜性心包积液, 乳糜胸

Abstract:

Abstract：ObjectiveTo report a newborn case of congenital idiopathic chylopericardium associated with chylothorax about its clinical features，ancillary diagnostic tests，treatment and prognosis. MethodsA newborn case diagnosed with congenital idiopathic chylopericardium associated with chylothorax was admitted to the Pediatric Intensive Care Unit of Provincial Hospital Affiliated to Shandong University. Its clinical features，treatment and follow-up data were analyzed，and a brief review of the literature was presented. ResultsBulk chylopericardium associated with chylothorax was detected with ultrasonography in fetus during antepartum. The child presented no obvious symptoms after birth. Chest X-ray demonstrated enlargement of the cardiac silhouette （cardiac/chest ratio was 0.75）. Echocardiography revealed pericardial effusion. Computed tomography of the chest did not reveal any lesion obstructing the thoracic duct. The chylous nature of the fluid was confirmed by demonstration of chylomicrons and high levels of triglycerides at puncture pricardiocentesis. After pericardial drainage by pricardiocentesis for three times failed，a catheter was left in the pericardium for drainage. Two days later the patient was cured. At 1 week and 1 month after operation he was doing well and echocardiography did not reveal any signs of recurrence. Conclusion Primary idiopathic chylopericardium is a rare clinical entity with obscure etiology. In most cases chylopericardium is only confirmed by pericardiocentesis. Pericardiocentesis and pericardial drainage are effective conservative treatment options. Surgery should be considered for the patients with recurring chylopericardium.

Key words: pericardial effusions, idiopathic primary chylopericardium, chylothorax