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Loculated mediastinal chylothorax resulting from esophagogastrectomy: a case report
J L Lautin1, S Baran, O Dumitrescu
1Department of Radiology, Mt. Sinai School of Medicine, New York, NY 10029.
Journal of Thoracic Imaging
|January 1, 1993
Summary
Injury to the thoracic duct during esophagogastrectomy typically causes chylous pleural effusions. This case details an unusual instance where a large mediastinal lymph collection formed without pleural violation.
Area of Science:
- Thoracic surgery
- Surgical anatomy
- Gastrointestinal surgery
Background:
- The thoracic duct, a major lymphatic vessel, runs near the esophagus and pleura.
- Esophagogastrectomy carries a risk of thoracic duct injury.
- Thoracic duct injury commonly leads to chylous pleural effusions.
Observation:
- A patient undergoing esophagogastrectomy experienced an injury to the thoracic duct.
- The injury did not involve violation of the pleura.
- A significant collection of lymph accumulated in the mediastinum.
Findings:
- An uncommon presentation of thoracic duct injury post-esophagogastrectomy.
- Mediastinal lymph collection occurred without the typical chylous pleural effusion.
- This suggests alternative pathways or mechanisms for lymph accumulation.
Implications:
- Highlights the complex anatomy and potential injury patterns of the thoracic duct.
- May necessitate revised diagnostic and management strategies for thoracic duct injuries.
- Broadens understanding of lymphatic fluid dynamics following upper gastrointestinal surgery.