Review the typical anatomy of the thoracic duct. Outline the causes of thoracic duct injury and the indications for thoracic duct embolization. Review thoracic duct embolization pre-procedural imaging such asmagnetic resonance ductography andlymphangiography. Describe thoracic duct embolization intra-procedural techniques including: cut-down,
lymphatic duct isolation,
and pedallymphangiography,lowerextremity lymphangiography,
cisterna chyli access and cannulization,thoracic duct...
The thoracic duct is the largest lymphatic conduit,
draining upwards of seventy-five percent of lymphatic fluid,
and extending from the cisterna chyli to the left jugulovenous angle.
The lengthy course of the thoracic duct predisposes it to injury from a variety of iatrogenic causes including: thoracic,
and head and neck surgeries as well as spontaneous benign or malignant lymphatic obstructions.
Disruption of the thoracic duct frequently results in chylothoraces that subsequently...
Findings and procedure details
Anatomy of the Thoracic Duct: Tubular structure extending from cisterna chyli at the the second lumbar vertebral bodyto the junction of the left subclavian and left interval jugular veins [1,2]. Originates at the abdominal cisterna chyli,
extends along the posterior aspect of the aorta and right diaphragmatic crus,
and enters the thorax between the aorta and azygos vein. Courses through the posterior mediastinum deep to the esophagus and pericardium. Enters the superior mediastinum at the...
The thoracic duct may be injured in a variety of surgical procedures as well as obstructing processes,
predisposing individuals to chylothoraces,
andpostoperative chylous wound leakages,
leading tonutritional depletion and impaired respiratory function.Knowledge of thoracic duct anatomy coupled with awareness of appropriate thoracic duct embolization techniques allows highly successful treatment with minimal morbidity or mortality.
Jeffrey Forris Beecham Chick,
MPH PGY V Department of Radiology Brigham and Women's Hospital Harvard Medical School firstname.lastname@example.org Nikunj Rashmikant Chauhan,
MD PGY V Department of Radiology Brigham and Women's Hospital Harvard Medical School email@example.com Alisa Siziki Han,
MD Instructor of Radiology Brigham and Women's Hospital Harvard Medical School firstname.lastname@example.org
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Primary chylopericardium: a review of the literature and an illustrated case.
Am Heart J.
1975;89(3):369-377.  Itkin M,
Spontaneous chylopericardium: delineation of the underlying anatomic pathology by CT...