Isolated chylopericardium

An occurrence of isolated chylopericardium in a 27 year old man is described. The asymptomatic nature of this disease in some patients is emphasized to reveal the chronic course of the process. No cause was found for the development of the chylopericardium. However, lymphangiography of the lower limbs demonstrated the communication between the branches of the thoracic duct and the pericardial sac and the point of obstruction of the thoracic duct at the level of the fistulous communication. To our knowledge, this is the first demonstration of a communication between the lymphatic vessels of the thoracic cavity and the pericardium associated with the development of chylopericardium. External drainage of the pericardial sac by means of a pericardial window using the subxyphoid route resulted in complete relief of the pericardial effusion. No recurrence of the chylopericardium was observed in this patient up to 8 months after the external drainage.