Chylous pericardial tamponade in a haemodialysis patient with catheter-associated thrombosis of internal jugular and subclavian veins.

Chylous pericardial effusion may occur after cardiothoracic surgery or in association with congenital lymphangiomatosis. Other causes may include chest trauma, mediastinal radiation, malignant neoplasm of the mediastinum or thrombosis of the subclavian vein and superior vena cava [1]. Idiopathic chylopericardium has also been described, most commonly in children and young adults [1]. Cardiac tamponade due to chylopericardium has been described in several of these cases. Pericardial disease with effusion and tamponade is not a rare complication in end-stage renal disease (ESRD) patients [2]. The aetiology of pericardial effusions can be transudative with no known aetiology, exudative secondary to malignancy or infection, or haemorrhagic secondary to uraemia. Chylous pericardial effusion in patients with ESRD is distinctly rare, with one case referenced in the surgical literature [3]. There are no reports of pericardial tamponade due to chylous effusion in dialysis patients. We present a patient admitted with chylopericardium.