Primary chylopericardium recovered without surgical treatment.--Report of a case and review of the literature.

A case of 7-year-old girl who had recurrent chylopericardium is presented. She was asymptomatic and physical examination disclosed only enlarged cardiac dullness on percussion and distant cardiac sound on auscultation. In despite of numerous pericardiocentesis, institution of medium-chain triglyceride diet and corticosteroid therapy, chylous pericardial effusion persisted. Four years later the amount of pericardial effusion began to decrease and 5 years later it disappeared completely. Her cardiac size became normal on the chest X-ray. She remained totally asymptomatic throughout the course of this disease. If the patient is asymptomatic and can well tolerate daily life, surgery is not necessarily indicated, and the patients should be treated medically as long as possible. A review of previously reported cases are given.