Volume : VIII, Issue : II, February - 2018

Variations of thoracic duct in its course in south Indian population

Bernard Ritchie, K. Praveena Kumari

Abstract :

 

Thoracic duct is the largest lymphatic channel draining the lymph and chyle from whole of the body below the diaphragm and left side of the body above the diaphragm. In 1647 Jean Pecquet (1622–1674) discovered the thoracic duct while working on animal dissection. He was an anatomist of Paris at that time. Pecquet reported his findings in “Experiment nova anatomica” in 1651. The year after that Johannes Van Hoorne, a Dutch professor, he himself independently discovered the thoracic duct and observed in human body.

Thoracic duct arises as a dilatation known as cisterna chyli. The cisterna chyli lies at the level of L1–L2 deep to the right crus of the diaphragm. It passes through the aortic opening to the right of the aorta. It ascends in the posterior mediastinum between the verteal column and oesophagus, with the descending thoracic aorta on left side and azygos vein on the right side. At the level of body of the 5th thoracic verteae, the duct gradually inclines to the left and enters the superior mediastinum. In the superior mediastinum the duct is crossed anteriorly by arch of aorta and then runs posterior to the initial segment of left subclavian artery.  Then it ascends along the left border of oesophagus up to the transverse process of 7th cervical verteae. At the level of C7 it leaves the oesophagus and arches laterally behind the carotid sheath in front of the apex of pleura and then downwards across the front of the subclavian artery to end by opening into commencing of achiocephalic vein (junction between left internal jugular vein and left subclavian vein).

            When the duct is blocked or damaged a large amount of lymph can quickly accumulate in the pleural cavity, this situation is called Chylothorax. Chronic inflammatory conditions like tuberculosis of lung, Sarcodiosis and other granulomatous diseases involving the posterior mediastinal lymph nodes may cause compression or obstruction of the thoracic duct. The conditions Chylothorax, Chyluria, thoracic duct cyst, cervical thoracic duct fistulas, Chylous ascites which are sometimes fatal. Hence variations of the thoracic duct are of extreme importance to a thoracic surgeon.

            With the recent advances by radio imaging techniques like Helical Multi  detector–Row computed Tomography, Computerized Tomography scanning (C.T), Ultrasonography, Lymphoscintigraphy, Lymphangiography, Near–Infrared fluorescence imaging, MRI (magnetic resonance imaging), and also catheterization of thoracic duct are being successfully under taken to demonstrate the course of the thoracic duct.

Keywords :

Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Bernard Ritchie, K. Praveena Kumari, Variations of thoracic duct in its course in south Indian population, INDIAN JOURNAL OF APPLIED RESEARCH : Volume-8 | Issue-2 | February-2018


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