第18巻 2022年8月　第3号

■症例報告

部分弓部大動脈人工血管置換術後に合併した乳糜心嚢液に対してソマトスタチンアナログ製剤投与とリンパ管造影検査が有効であった1例
山下　裕正¹, 藤井　正大¹, 井塚　正一郎¹, 網谷　亮輔¹, 川瀬　康裕¹, 嶺　貴彦², 別所　竜蔵¹, 石井　庸介^3
1日本医科大学千葉北総病院心臓血管外科
²日本医科大学千葉北総病院放射線科
³日本医科大学付属病院心臓血管外科

Chylopericardium after Partial Arch Replacement Treated with Somatostatin Analog Administration and Lymphatic Embolization by Lymphangiography
Hiromasa Yamashita¹, Masahiro Fujii¹, Syouichirou Iduka¹, Ryousuke Amitani¹, Yasuhiro Kawase¹, Takahiko Mine², Ryuzo Bessho¹ and Yousuke Ishii^3
1)Cardiovascular Surgery, Nippon Medical School Chiba Hokusoh Hospital
²⁾Radiology, Nippon Medical School Chiba Hokusoh Hospital
³⁾Cardiovascular Surgery, Nippon Medical School Hospital

A 72-year old woman was transferred to our emergency department for evaluation of chest and back pain. She was diagnosed with Stanford type A aortic dissection based on computed tomography findings, and we performed emergency partial arch graft replacement on the same day. The patient was extubated the day following surgery, and oral intake was resumed on the second postoperative day. We observed cloudy drainage in the pericardial drain following the first feed and diagnosed the patient with chylopericardium based on biochemical evaluation findings. Continued drainage necessitated lymphangiography, which was performed on the 7^th postoperative day and revealed lymphatic outflow on the aortic arch lesser curvature side. The volume of drainage decreased subsequently and did not increase thereafter following resumption of oral intake. The patient was discharged on the 27^th postoperative day without any additional treatment.

日医大医会誌 2022; 18(3), 294-298

Key words
chylopericardium, lymphangiography, acute aortic dissection

Correspondence to
Hiromasa Yamashita, Cardiovascular Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba 270-1694, Japan
E-mail：hiro@nms.ac.jp

受付：2022年4月1日　受理：2022年5月16日