内科治療可能であったPrimary Chylopericardiumの1例

A Case of Primary Chylopericardium Followed up Medically

　症例は，19歳女性．感冒に引き続く全身のむくみがあり，胸部X線写真で心拡大が認められ，精査目的で当院を紹介された．心嚢液貯留著明で，心嚢穿刺による心嚢液の性状は乳糜であった．胸部CTに異常なく，外傷，胸部の手術の既往もなく，特発性と考えられた．利尿剤投与で心嚢液は減少し，以後心嚢穿刺を必要とすることはなかった．Primary Chylo-pericardiumの治療は，ほとんどが手術であり，自然に心嚢液が消失したという報告はまだ1例しかない．本症例は，普段無症状であり，利尿剤投与で心嚢液が減少したので内科的に経過観察している．

A 19-year-old female was referred to the hospital complaining of systemic edema following a common cold. Chest X ray showed cardiomegaly. Echocardio-graphy showed massive cardiac effusion. The charac-teristics of the effusion indicated chylious fluid. Thor-acic computed tomography showed no abnormality in the mediastinum. The patient had no injury and had undergone no operation damaging the thoracic duct. Therefore, this was a case of primary chylopericar-dium. Treatment of chylopericardium in most cases is surgical operation. There has been only one case in which the patient recovered without surgical treatment. This case was asymptomatic in daily life. Moreover, cardiac effusion gradually decreased under the influence of diuretics. We have been treating her medically.