Chylopericardial tamponade complicating oesophago-gastrectomy.
within the mediastinum via the right paratracheal lymph nodes and the left superior bronchial lymph nodes w7x. In addition, lymph drainage from the lateral and posterior aspects and the diaphragmatic surface of the pericardium has been shown to channel into various different groups of mediastinal lymph nodes including the juxta-oesophageal group w8x. It is therefore feasible that lymphatic drainage of the heart and pericardium was interrupted during the additional mediastinal dissection undertaken during the second surgical procedure, leading to the accumulation of chyle within the pericardium. Although it is thought that intra-thoracic lymphatic pathways are relatively constant w7x, it is perfectly possible that a rarely encountered anatomical variant may have been the cause, which would explain the lack of precedent for this report.