Chylothorax and chylopericardial tamponade following lobectomy and lymphadenectomy: a rare presentation

BACKGROUND: Although postoperative chylothorax following lung cancer surgery is rare, it is a recognized complication in 0.25–3% of patients. However, cases of cardiac tamponade caused by chylopericardium after lung cancer surgery are extremely rare. CASE PRESENTATION: We describe hitherto unreported sequelae of chyle leak following lobectomy and systematic mediastinal lymph node dissection (SLND) causing pericardial tamponade and cardiovascular compromise. The patient was successfully treated with minimally invasive surgical repair and ligation. We also discuss the development of chylopericardium as a potential complication of lobectomy and SLND. CONCLUSIONS: The anatomical characteristics of the thoracic duct warrant special attention in postoperative chyle leak management in patients who undergo definitive mediastinal lymph node dissection. Surgeons should be aware that chylopericardium is a rare but potential complication of lobectomy and SLND as it may help with early diagnosis, management, and prevention of cardiac tamponade. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13019-023-02126-3.