Surgical treatment of chylous fistula usually involves ligation of the thoracic duct
. Repeated surgical procedures because of complications with postoperative chylous fistula have to be underwent up to 11% of the patients, and 9% experienced recurrence of their chylous fistula (2).
Treatment of these disorders focuses on decreasing chyle production by dietary modifications (i.e., a low fat diet excluding long-chain triglycerides, TPN ), pharmacologic therapies (including octreotide , midodrine ), and/or surgical intervention (i.e., thoracic duct
These conditions are usually caused by obstruction and/or disruption of the thoracic duct
or one of its major divisions in the chest and abdomen., Diagnosis of chylous ascites and chylothorax depends on the analyses of ascites and pleural effusion.
The contemporary management of chyle leak following cervical thoracic duct
Alternatively, sudden compression of the lipemic and engorged mesenteric lymphatics, adjacent nodes, and lower thoracic duct
aggravated by deformations associated with stretching and tearing motions may also directly disrupt chyle containing lymphatics (6).
Evidence suggests that microscopic disruptions in lymphatic channels lead to chylous effusions following dasatinib therapy rather than macro-level classical thoracic duct
The thoracic duct
forms during the 8th week of gestation as two distinct vessels anterior to the aorta, connecting the superior jugular lymph sacs to the inferior cisterna chyli.
(c) Thoracic duct
(TD) formation was blunted to a moderate (c') to sever (c") degree in tmsb-like-MO animals compared to proper TD formation in control animals 5.5 days postfertilization (dpf, (c), arrowhead).
Earlier reports of increased rates of thoracic duct
flow and radio-isotope appearance in the thoracic duct
following ureteral obstruction further support the re-absorption concept.
Lymphedema (lymphoedema in British English), also known as lymphatic obstruction, is a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system, which normally returns interstitial fluid to the thoracic duct
and then the bloodstream.
Then, there was isolation of the thoracic duct
We encountered 2 chyle leaks, and both required thoracotomy and ligation of thoracic duct
. Reexploration was required in 3 (5.88%) patients, 2 had chyle leak, while 1 had collection in mediastinum.