Key result
Pericardiectomy alone resolves chylothorax secondary to constrictive pericarditis by lowering CVP.
Why the study?
Pericardial constriction caused by repeated chest trauma from boxing is a rare and under-recognized clinical entity.
Case Report (n=1)
May support pericardiectomy in refractory chylothorax with constriction; hypothesis-generating for trauma-related cases and requires validation.
A 65-year-old retired professional boxer presented with progressively worsening shortness of breath, peripheral oedema and mild abdominal swelling over a period of 6 months. His only past medical history was hypertension. Subsequent investigations revealed chylous ascites, pericardial constriction and bilateral chylothorax. He had uneventful pericardectomy, and post-operatively the chylothorax resolved only after administration of octreotide for 10 days. The histopathological features of fibrosis, haemosiderin deposition in the pericardium and abundant haemosiderin-laden macrophages are consistent with chronic resolving haemopericardium. These findings suggested that the cause of pericardial constriction was repeated chest trauma from boxing.
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A 2003 study conducted a case report in Constrictive pericarditis with chylothorax (n=1). Pericardiectomy was evaluated. Pericardiectomy alone successfully resolved chylothorax secondary to postoperative constrictive pericarditis by reducing central venous pressure and enhancing mediastinal lymphatic drainage.
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