Chilopericardium is the presence of chyle within the pericardium. If the effusion is significant (>1500 ml) or occurs rapidly (>200 ml), it can lead to cardiac tamponade, requiring immediate drainage. In most cases, a fistulous tract can be observed between the mediastinal lymphatic structures (thoracic duct) and the pericardium. More frequently, this occurs due to lymphangiectasia or a traumatic event (including iatrogenic causes). 

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