JACC. Case reports · 2026
Chylous Collection in the Pacemaker Pocket Masquerading as Infection.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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O'Neill Alanna C, Zhu Vanessa, Marentis Theodore, Wu Thomas, Aryana Arash
Аннотация
BACKGROUND: Although a largely safe procedure, a variety of complications may arise from pacemaker implantation. One rare complication involves chylous collections forming at the pacemaker pocket.
CASE SUMMARY: A 58-year-old woman with myotonic dystrophy and a dual-chamber pacemaker presented with chronic swelling over her pacemaker site. Imaging revealed a large fluid collection. Needle aspiration yielded 600 mL of milky, odorless fluid with a triglyceride level of 403 mg/dL, consistent with a chylous effusion. Lymphangiography and lymphoscintigraphy suggested impaired thoracic duct drainage, likely secondary to iatrogenic injury during pacemaker implantation. The patient was managed with a low-fat diet and remained asymptomatic without recurrence.
DISCUSSION: Chylous fluid collections in pacemaker pockets are a rarely documented postsurgical complication. Understanding of diagnosis and treatment of this complication remains poorly explored.
TAKE-HOME MESSAGE: This case emphasizes the need to consider lymphatic disruption in patients with persistent device site fluid collections.
CASE SUMMARY: A 58-year-old woman with myotonic dystrophy and a dual-chamber pacemaker presented with chronic swelling over her pacemaker site. Imaging revealed a large fluid collection. Needle aspiration yielded 600 mL of milky, odorless fluid with a triglyceride level of 403 mg/dL, consistent with a chylous effusion. Lymphangiography and lymphoscintigraphy suggested impaired thoracic duct drainage, likely secondary to iatrogenic injury during pacemaker implantation. The patient was managed with a low-fat diet and remained asymptomatic without recurrence.
DISCUSSION: Chylous fluid collections in pacemaker pockets are a rarely documented postsurgical complication. Understanding of diagnosis and treatment of this complication remains poorly explored.
TAKE-HOME MESSAGE: This case emphasizes the need to consider lymphatic disruption in patients with persistent device site fluid collections.