Two cases of adult hydrocephalic patients who underwent ventriculolymphatic shunt procedures with good results are reported. The anatomy of the terminal portion of the thoracic duct documented by previous authors with the operative technique of the ventriculo-thoracic duct shunting procedure is described and the advantage of the function of the shunt as compared with that of the ventriculoatrial shunt is added.
Adult ; Humans ; Thoracic Duct

Thoracic duct cysts are very rare. They are usually asymptomatic but sometimes cause compressive effects on structures near them due to enlarged supraclavicular mass. The etiology of thoracic duct cysts is not fully understood, but the possibility of congenital weakness or atherosclerotic changes of ductal wall, trauma, and inflammatory reactions have been suggested. Although image studies are helpful, the excision of mass and the histological studies are needed for definite diagnosis. We now report this extremely rare case of cervical thoracic duct cyst in the left supraclavicular fossa, including its diagnostic methods and pathogenesis.
Diagnosis ; Neck ; Thoracic Duct*

The thoracic duct cyst is an extremely rare cystic lesion in the mediastinum. Surgical treatment of the cyst is necessary to confirm histologic diagnosis and prevent potential complications such as spontaneous or traumatic rupture of the cyst and chylothorax.
Chylothorax ; Mediastinum ; Rupture ; Thoracic Duct

Cysts of thoracic duct are uncommon. The most commonly involved site is the thoracic segment of the thoracic duct followed by the abdominal and cervical segments of the thoracic duct. To date, about 15 cases of cervical thoracic duct cysts have been described in the literature. Information regarding the natural history of these cysts and their pathogenesis is limited. The primary symptom and sign are generally a palpable soft left supraclavicular swelling. We report a case of cervical thoracic duct cyst with a review of literature.
Natural History ; Neck ; Thoracic Duct*

Chyle is the digestive product absorbed from intestinal lymphatics which the component have high concentration of triglyceride and protein. The various pathological circumstances which give rise to intrathoracic effusion of chyle are well documented and so the etiology is clearly defined in most instances. However, the occurrence of chylothorax in early infancy, in the absence of other demonstrable diseases and without apparent birth trauma, suggests the existence of congenital malformation of the thoracic ducts. We lately experienced a 20 day old new born who was proved to have congenital chylothorax by clinical history and laboratory findings. So we report the clinical findings and laboratory findings with the review of the literatures on congenital chylothorax.
Chyle ; Chylothorax* ; Parturition ; Thoracic Duct ; Triglycerides

Traditional surgical management of chylothorax refractory to conservative treatment is thoracic duct ligation through a right open thoracotomy. A new surgical procedure of ligation of the thoracic duct via extrapleural approach is presented. Its advantages are less invasive, no need of a new drainage tube, and easier to expose the thoracic duct than the conventional transthoracic approach. We experienced a new surgical method in the treatment of the chylothorax and report it with literatures.
Chylothorax* ; Drainage ; Ligation* ; Thoracic Duct* ; Thoracotomy

Dynamic enhanced magnetic resonance lymphangiography can be used to provide anatomic and dynamic information for various lymphatic diseases, including thoracic duct injury, and can also help to guide the thoracic duct embolization procedure. We present a case of postoperative chylothorax demonstrated by dynamic enhanced MR lymphangiography. In this case, the chyle leakage site and location of cisterna chyli were clearly visualized by dynamic enhanced MR lymphangiography, thus allowing for management with thoracic duct embolization.
Chyle ; Chylothorax ; Lymphatic Diseases ; Lymphography ; Thoracic Duct

A chyle leakage occurs due to injuries m the thoracic duct or the accessory lymphatic channels in the neck or the upper chest. The most common causes of chyle leakages are trauma and neoplasm, and spontaneous chyle leakages are infrequently en- countered. There are few cases of spontaneous chyle leakage reported in the literature. Recently, we experienced a case of spontaneous chyle leakage presenting as supraclavicular swelling following severe coughing. We report this case with a review of literature.
Chyle* ; Cough ; Neck ; Thoracic Duct ; Thorax

Postoperative chylothorax following an injury to the thoracic duct during an esophagectomy is a rare, but severe complication, which may lead to serious problems, such as loss of fat and proteins, as well as immunodeficiency. Left untreated, the rate of mortality can rise to over 50%. Herein, 3 patients were treated with a postoperative chylothorax following 280 resections of the esophagus (0.1%). One patient underwent a direct injured thoracic duct ligation by a re-thoracotomy. In the other two patients, relaparotomy and transabdominal double ligation of the thoracic duct were performed. After ligation of the abdominal thoracic duct, the average amount of chyle was markedly reduced. Two patients were discharge from hospital without problems after 36 and 30 days, respectively. Ligation of the thoracic duct, via a relaparotomy, appears to be a simple and safe method for the treatment postoperative chylothorax.
Chyle ; Chylothorax* ; Esophagectomy* ; Esophagus ; Humans ; Ligation* ; Mortality ; Thoracic Duct*

The cisterna chyli, a dilated lymphatic sac in the retrocrural space, is usually located to the right of the aorta. We report a case of a left-sided cisterna chyli, which was incidentally detected on the radiologic examinations of a preoperative workup for cholangiocarcinoma. Computed tomography (CT) and magnetic resonance (MR) images revealed a cisterna chyli measuring 2.5 cm in length in the left retrocrural space. The dilated lumbar lymphatics joined with the cisterna chyli, which was continuous with the left-sided thoracic duct. To the best of our knowledge, this is the second antemortem case of a left-sided cisterna chyli in literature. The cisterna chyli can mimic retrocrural lymphadenopathy, solid tumor with cystic degeneration, abscess or hematoma. The left-sided cisterna chyli should be referred to as a structure so as to be cautious in surgical approach.
Abscess ; Aorta ; Cholangiocarcinoma ; Hematoma ; Lymphatic Abnormalities ; Lymphatic Diseases ; Thoracic Duct