We used video-assisted thoracoscopic surgery to successfully treat primary chylopericardium, a very rare disease. A 27-year-old woman was admitted to our hospital for investigation of cardiomegaly and dyspnea on exertion. Echocardiography showed severe peri-cardial effusion. A milky fluid was extracted by pericardiocentesis and diagnosed as being chylous. A computed tomography (CT) scan taken after lymphangiography showed the leakage of contrast solution into the pericardial cavity. Initially, conservative therapy was used to treat the condition, but this proved ineffective and we decided to perform video-assisted thoracoscopic surgery. The thoracic duct was ligated and excised, and partial pericardiectomy was carried out under thoracoscopy. The patient has been in good health with no sign of recurrence since her operation. Thus, video-assisted thoracoscopic thoracic duct ligation and partial pericardiectomy can be effectively used to treat primary chylopericardium.
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