Overview

The thoracic duct is the main lymphatic channel returning lymph from the lower body and left upper quadrant to the venous circulation at the left subclavian vein. It transports chyle and immune cells and is vulnerable to injury during thoracic surgery. Lymphatic anatomy influences edema and chylothorax risk.

Anatomic Course

The thoracic duct ascends through the posterior mediastinum crossing to the left at the thoracic inlet before draining into the venous system. Variants and accessory ducts are common and affect surgical risk. Lymphangiography maps duct anatomy for intervention.

Pathology and Complications

Thoracic duct injury causes chylothorax with pleural effusion rich in triglycerides and lymphocytes. Lymphatic malformations and obstruction lead to lymphedema and chylous ascites. Interventional radiology and surgery address leaks and obstructions.

Clinical Relevance

Understanding thoracic duct anatomy is essential for thoracic surgery trauma and cancer care. Imaging lymphangiography and targeted embolization treat chyle leaks and lymphatic disorders. Multidisciplinary management optimizes outcomes.