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1

Savla, Jill J., Benjamin Kelly, Emil Krogh, et al. "Occlusion Pressure of the Thoracic Duct in Fontan Patients With Lymphatic Failure: Does Dilatation Challenge Contractility?" World Journal for Pediatric and Congenital Heart Surgery 13, no. 6 (2022): 737–44. http://dx.doi.org/10.1177/21501351221119394.

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Background The Fontan circulation challenges the lymphatic system. Increasing production of lymphatic fluid and impeding lymphatic return, increased venous pressure may cause lymphatic dilatation and decrease lymphatic contractility. In-vitro studies have reported a lymphatic diameter-tension curve, with increasing passive stretch affecting the intrinsic contractile properties of each thoracic duct segment. We aimed to describe thoracic duct occlusion pressure and asses if thoracic duct dilation impairs contractility in individuals with a Fontan circulation and lymphatic failure. Methods Centr
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2

Mohiyuddin, Dr S. M. Azeem. "Traumatic Chlye Leak In Neck: An Uncommon and Serious Complication." JOURNAL OF CLINICAL AND BIOMEDICAL SCIENCES 9, no. 2 (2019): 29–30. http://dx.doi.org/10.58739/jcbs/v09i2.4.

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The lymph from the entire left side of body and right side of body below the diaphragm flows through the thoracic duct. The lymph from rest of the body flows through the right thoracic duct. It also carries chyle from intestines, partially digested long chain fatty acids and chylomicrons. The tho-racic duct develops from the fusion of the 2 lymphatic ducts present from the 8th week of intrauterine life and fuse before birth. There can be connections between remnants of the 2 lymphatic ducts or branching from the thoracic duct. The thoracic duct originates from cisterna chyli situated at the le
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3

Yang, Sijun, Dingzong Guo, and Yaobaoan. "Histopathology of the lymphatic system in ascitic broilers." Veterinární Medicína 47, No. 9 (2012): 264–69. http://dx.doi.org/10.17221/5833-vetmed.

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Histomorphologic changes of the lymphatic system of the liver and thoracic duct were examined. The diameters of lymphatic segments isolated from the thoracic ducts of ascitic and normal broilers at 32 to 37 days of age were measured using an optical micrometer measurement system. e histopathological picture of the segments of lymphatic tissue showed lymphatic cysts bilaterally along the posterior vena cava. The hepatic capsule manifested edema, thickening, and cellular proliferation. Microscopic changes in lymphatic vessels of the hepatic capsule include lymph embolism, and lymphatic plasma r
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4

Kutara, Kenji, Teppei Kanda, Noritaka Maeta, et al. "Combining non-contrast enhanced magnetic resonance thoracic ductography with vascular contrast-enhanced computed tomography to identify the canine thoracic duct." Open Veterinary Journal 10, no. 1 (2020): 68–73. http://dx.doi.org/10.4314/ovj.v10i1.11.

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Background: In humans, visualization of the thoracic duct by magnetic resonance imaging (MRI) has been attempted, and recent advances have enabled clinicians to visualize the thoracic duct configuration in a less invasive manner. Moreover, MRI does not require contrast media, and it enables visualization of morphological details of the thoracic structures. In veterinary practice, the thoracic duct has not been visualized three dimensionally in MRI.Aim: This study aimed to assess the performance of our magnetic resonance thoracic ductography (MRTD) technique to visualize the thoracic duct and t
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5

Kim, Sungha, Sharon Jiyoon Jung, Sang Yeon Cho, Yoon Kyu Song, Kwang-Sup Soh, and Sungchul Kim. "A Method for the Observation of the Primo Vascular System in the Thoracic Duct of a Rat." Evidence-Based Complementary and Alternative Medicine 2013 (2013): 1–5. http://dx.doi.org/10.1155/2013/536560.

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Even though the primo vascular system (PVS) has been observed in large caliber lymph vessels by several independent teams, the presence of the PVS in the thoracic duct has been reported by only one team, probably because reproducing the experiment is technically difficult. This brief report presents a new, relatively straightforward method, which is a simple modification of the previous method of dye injection into the lumbar node, to observe the PVS in a thoracic duct of a rat by injecting Alcian blue into the renal node. When this new method was applied to a rat, the branching of the primo v
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6

Itkin, Maxim, and Eric Chen. "Thoracic Duct Embolization." Seminars in Interventional Radiology 28, no. 02 (2011): 261–66. http://dx.doi.org/10.1055/s-0031-1280676.

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7

Depypere, Lieven, Willy Coosemans, Philippe Nafteux, et al. "Thoracic duct supradiaphragmatic." ASVIDE 4 (March 2017): 86. http://dx.doi.org/10.21037/asvide.2017.086.

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8

Kato, Takumi, Kei Takase, Hirofumi Ichikawa, Susumu Satomi, and Shoki Takahashi. "Thoracic Duct Visualization." Journal of Computer Assisted Tomography 35, no. 2 (2011): 260–65. http://dx.doi.org/10.1097/rct.0b013e31820a0b0e.

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9

L??PEZ, OSCAR LUIS, EDUARDO RODR??GUEZ-MAISANO, and JOS?? LUIS DELEVAUX. "Thoracic Duct Malformations." Clinical Nuclear Medicine 11, no. 7 (1986): 479–81. http://dx.doi.org/10.1097/00003072-198607000-00003.

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10

López-Gutiérrez, Juan Carlos. "Thoracic Duct Embolization, Unexplained Thoracic Duct Occlusions, and Lymphatic Anomalies." Chest 143, no. 2 (2013): 578–79. http://dx.doi.org/10.1378/chest.12-2097.

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11

P, Bapuji, Srinivasarao Yalakurthi, Thirupathirao Vishnumukkala, and Swayam Jothi Dorai Raj. "ANATOMICAL VARIATIONS OF THE HUMAN THORACIC DUCT." International Journal of Anatomy and Research 6, no. 4.2 (2018): 5861–68. http://dx.doi.org/10.16965/ijar.2018.362.

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12

Hart, Anna Kristina E., John H. Greinwald, Christopher I. Shaffrey, and Gregory N. Postma. "Thoracic duct injury during anterior cervical discectomy: a rare complication." Journal of Neurosurgery 88, no. 1 (1998): 151–54. http://dx.doi.org/10.3171/jns.1998.88.1.0151.

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✓ Chylous fistula resulting from intraoperative injury to the cervical thoracic duct is well described as a complication of neck dissection. However, injury to the thoracic duct during spinal surgery is rarely reported. The authors present the first case of thoracic duct injury occurring during cervical discectomy and fusion via an anterior approach. The anomalous location of the terminal arch of the thoracic duct in this patient contributed to the complication. The morbidity of chyle leakage is minimized by its early recognition, a thorough understanding of lymphatic system anatomy, and aggre
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13

Rouiller, Benoît, Jon A. Lutz, Gregor J. Kocher, and Lennart Magnusson. "Bilateral thoracic duct ligation for persisting postoperative chylothorax." Interactive CardioVascular and Thoracic Surgery 31, no. 4 (2020): 583–84. http://dx.doi.org/10.1093/icvts/ivaa128.

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Abstract Herein, we report the case of a patient with persistent postoperative chylothorax despite right supradiaphragmal ligation of the thoracic duct. Computed tomography lymphangiography after lipiodol injection demonstrated a correctly ligated right thoracic duct but an anatomical variation with patent left-sided thoracic duct, which was successfully ligated afterwards by video-assisted thoracic surgery.
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14

Ahmed, Shair U., Manu S. Sancheti, and Allan Pickens. "Thoracoscopic Thoracic Duct Ligation." Operative Techniques in Thoracic and Cardiovascular Surgery 17, no. 4 (2012): 292–301. http://dx.doi.org/10.1053/j.optechstcvs.2012.11.003.

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15

Chen, Fengshi, Toru Bando, Nobuharu Hanaoka, et al. "Mediastinal Thoracic Duct Cyst." Chest 115, no. 2 (1999): 584–85. http://dx.doi.org/10.1378/chest.115.2.584.

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16

Gupta, Maneesh, Todd D. Lovelace, Mithran Sukumar, and Marc V. Gosselin. "Cervical Thoracic Duct Cyst." Journal of Thoracic Imaging 20, no. 2 (2005): 107–9. http://dx.doi.org/10.1097/01.rti.0000148208.74252.84.

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17

Mortman, Keith D. "Mediastinal Thoracic Duct Cyst." Annals of Thoracic Surgery 88, no. 6 (2009): 2006–8. http://dx.doi.org/10.1016/j.athoracsur.2009.04.138.

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18

Ray, J., D. Braithwaite, and P. Patel. "Spontaneous thoracic duct cyst." European Archives of Oto-Rhino-Laryngology 260, no. 5 (2003): 280–82. http://dx.doi.org/10.1007/s00405-002-0484-8.

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19

Brauchle, Randall W., Seymon A. Risin, Rhonda P. Ghorbani, and Kevin D. Pereira. "Cervical Thoracic Duct Cysts." Archives of Otolaryngology–Head & Neck Surgery 129, no. 5 (2003): 581. http://dx.doi.org/10.1001/archotol.129.5.581.

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20

McGraw, J. Reed, Maxim Itkin, and Stephen J. Kovach. "Lymphangiography-Guided Thoracic Duct Surgical Lymphovenous Bypass for Distal Thoracic Duct Occlusion." Journal of Vascular and Interventional Radiology 34, no. 8 (2023): 1472–73. http://dx.doi.org/10.1016/j.jvir.2023.04.004.

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21

Perwaiz, Azhar, Amanjeet Singh, and Adarsh Chaudhary. "RA01.02: THORACIC DUCT LIGATION DURING THORACOSCOPIC RADICAL ESOPHAGECTOMY." Diseases of the Esophagus 31, Supplement_1 (2018): 18. http://dx.doi.org/10.1093/dote/doy089.ra01.02.

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Abstract Description What is this video? This video is about ligation of thoracic duct during thoracoscopic radical esophagectomy for carcinoma esophagus with focus on where to search for thoracic duct during medistinal dissection. Why this video is unique? Routine ligation of thoracic duct during radical esophagectomy does not assure against post operative chyle leak but is can reduce incidence of clinically signifiant chyle leaks and need of invasive procedure to manage it. The video aims for post graduates teaching and for beginners and can be a usefull guide to search for thoracic duct whi
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22

Kerpsack, Stephen J., Mary A. McLoughlin, Stephen J. Birchard, Daniel D. Smeak, and David S. Biller. "Evaluation of mesenteric lymphangiography and thoracic duct ligation in cats with chylothorax: 19 cases (1987–1992)." Journal of the American Veterinary Medical Association 205, no. 5 (1994): 711–15. http://dx.doi.org/10.2460/javma.1994.205.05.711.

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Summary Mesenteric lymphangiography and thoracic duct ligation were performed on 19 cats with chylothorax between 1987 to 1992. Chylothorax was diagnosed on the basis of detection of chylomicrons in the pleural effusion or determination of a cholesterol concentration:triglyceride concentration ratio of < 1 in the pleural fluid. Preoperative medical treatment consisted of thoracentesis (19 of 19 cats) and feeding a fat-restricted diet (14 of 19 cats). Positive-contrast mesenteric lymphangiography was performed before thoracic duct ligation to identify an underlying cause for the effusion. Ly
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23

Saito, Akira, Natsuka Kimura, Yuji Kaneda, et al. "Novel Drug Delivery Method Targeting Para-Aortic Lymph Nodes by Retrograde Infusion of Paclitaxel into Pigs’ Thoracic Duct." Cancers 14, no. 15 (2022): 3753. http://dx.doi.org/10.3390/cancers14153753.

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Gastrointestinal cancer with massive nodal metastases is a lethal disease. In this study, using a porcine model, we infused the anti-cancer drug Paclitaxel (PTX) into thoracic ducts to examine the efficiency of drug delivery to intra-abdominal lymph nodes. We established a technical method to catheterize the thoracic duct in the necks of pigs. We then compared the pharmacokinetics of PTX administered intrathoracically with those of systemic (intravenous) infusion. Serum, liver, and spleen concentrations of PTX were significantly lower following thoracic duct (IT) infusion than after intravenou
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24

Dar, Parvez Mohi Ud Din, Shivanand Gamanagatti, Pratyusha Priyadarshini, and Subodh Kumar. "Traumatic chylothorax: a dilemma to surgeons and interventionists." BMJ Case Reports 14, no. 5 (2021): e238961. http://dx.doi.org/10.1136/bcr-2020-238961.

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Chylothorax is generally seen due to iatrogenic injury to the thoracic duct during thoracic or neck surgery. It can also be encountered secondary to chest trauma either blunt or penetrating. Percutaneous thoracic duct embolisation is an alternative to surgical treatment and is considered an effective and safe minimally invasive treatment option for chylothorax with a success rate of about 80%. We present a case of blunt trauma to the chest with chylothorax, which was successfully managed with transvenous retrograde thoracic duct embolisation.
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25

Klodell, C. T. "Nonoperative thoracic duct embolization for traumatic thoracic duct leak: Experience in 109 patients." Yearbook of Surgery 2011 (January 2011): 372–73. http://dx.doi.org/10.1016/s0090-3671(10)79914-6.

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26

Itkin, Maxim, John C. Kucharczuk, Andrew Kwak, Scott O. Trerotola, and Larry R. Kaiser. "Nonoperative thoracic duct embolization for traumatic thoracic duct leak: Experience in 109 patients." Journal of Thoracic and Cardiovascular Surgery 139, no. 3 (2010): 584–90. http://dx.doi.org/10.1016/j.jtcvs.2009.11.025.

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27

Kanabuchi, Sawa, Yusuke Taniyama, Tadashi Sakurai, et al. "PS02.145: TREATMENT FOR CHYLOTHORAX AFTER THORACIC ESOPHAGECTOMY." Diseases of the Esophagus 31, Supplement_1 (2018): 161–62. http://dx.doi.org/10.1093/dote/doy089.ps02.145.

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Abstract Background Chylothorax is relatively rare complication in esophagus cancer surgery. But once it happens, appropriate treatment is absolutely essential to avoid another severe complication. We report our treatment results of chylothorax after thoracoscopic esophagectomy and represent the appropriate treatment strategy for this complication. Methods We examined 468 patients who underwent thoracoscopic esophagectomy for esophageal cancer from January 2009 to November 2017. Thoracic duct was mostly preserved except the case which had cancer invasion. Also, MRI scan was performed in all ca
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28

Wang, Yan An, Zhi Yuan Zhang, Jia Wei Zheng, Wei Min Ye, Li Zhen Wang, and Han Guang Zhu. "Spontaneous thoracic duct cyst presenting as a left supraclavicular mass – report of a case and review of literature." Phlebology: The Journal of Venous Disease 24, no. 2 (2009): 82–84. http://dx.doi.org/10.1258/phleb.2008.008056.

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Spontaneous and asymptomatic supraclavicular thoracic duct cysts occurring in the neck are the rarest. We report a case of a huge thoracic duct cyst occurring in the supraclavicular fossa with a review of the literature and management options. A 28-year-old female had a left supraclavicular mass with a 10-year history. A cervical thoracic duct cyst was diagnosed after chemical analysis of the milky fluid obtained by preoperative fine-needle aspiration. Treatment was achieved by surgical excision of the cyst and thoracic duct ligation. Pathological analysis of the cyst after excision confirmed
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29

Brace, R. A., and G. J. Valenzuela. "Effects of outflow pressure and vascular volume loading on thoracic duct lymph flow in adult sheep." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 258, no. 1 (1990): R240—R244. http://dx.doi.org/10.1152/ajpregu.1990.258.1.r240.

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Studies have shown that lymph flow rate from several tissues depends on the pressure at the outflow end of the lymphatics. The left thoracic lymph duct is the largest lymphatic vessel and it transports a majority of the body's lymph. We varied outflow pressure for the left thoracic lymph duct independent of venous pressure in six unanesthetized, nonpregnant adult ewes with chronic lymphatic and venous catheters. When outflow pressure was negative, the thoracic duct lymph flow rate was independent of outflow pressure and averaged 0.040 +/- 0.004 (SE) ml.min-1.kg body wt-1. Lymph flow began to d
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30

Garner, Megan, Dileep Duvva, John Gosney, and Silviu Buderi. "Spontaneousrupture of a giant thoracic duct cyst presenting with abdominal pain and a tension chylothorax." Interactive CardioVascular and Thoracic Surgery 31, no. 5 (2020): 732–33. http://dx.doi.org/10.1093/icvts/ivaa177.

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Abstract Ruptured thoracic duct cysts are an extremely rare occurrence that may arise spontaneously or due to trauma. Surgical treatment is needed to provide a definitive diagnosis, drain the chylothorax and ligate the thoracic duct to prevent reoccurrence. We report the case of a woman with a ruptured thoracic duct cyst presenting with abdominal pain and subsequent tension chylothorax. To the best of our knowledge, this is the first such reported case.
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31

Telinius, Niklas, Nanna Drewsen, Hans Pilegaard, et al. "Human thoracic duct in vitro: diameter-tension properties, spontaneous and evoked contractile activity." American Journal of Physiology-Heart and Circulatory Physiology 299, no. 3 (2010): H811—H818. http://dx.doi.org/10.1152/ajpheart.01089.2009.

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The current study characterizes the mechanical properties of the human thoracic duct and demonstrates a role for adrenoceptors, thromboxane, and endothelin receptors in human lymph vessel function. With ethical permission and informed consent, portions of the thoracic duct (2–5 cm) were resected and retrieved at T7–T9 during esophageal and cardia cancer surgery. Ring segments (2 mm long) were mounted in a myograph for isometric tension (N/m) measurement. The diameter-tension relationship was established using ducts from 10 individuals. Peak active tension of 6.24 ± 0.75 N/m was observed with a
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32

Rodrigues, D., F. Leão, S. Siqueira, et al. "Anatomic variation of the thoracic duct and absence of accessory hemiazygos and hemiazygos veins: case report." Journal of Morphological Sciences 32, no. 03 (2015): 209–11. http://dx.doi.org/10.4322/jms.061614.

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AbstractThe thoracic duct is a lymph vessel extending from the abdomen to the base of the neck where it drains to one of the large veins in the region. Many cases are described in the scientific literature, regarding anatomical variations of the thoracic duct, from its origin, path, until its end, and the vast majority intended to relate variations in the last part of the duct. The reports related to variations of its path are very scarce. In a male cadaver dissection in the anatomy laboratory of the Faculdade de Ciências Médicas of Minas Gerais (FCMMG), an anatomical variation of the position
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33

Forney, Michael C., and Lana M. Wilkinson. "Case 180: Thoracic Duct Cyst." Radiology 263, no. 1 (2012): 301–4. http://dx.doi.org/10.1148/radiol.12092468.

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34

De Santis, Michele, Vitória Martins, Ana Luisa Fonseca, and Orlando Santos. "Large mediastinal thoracic duct cyst." Interactive CardioVascular and Thoracic Surgery 10, no. 1 (2010): 138–39. http://dx.doi.org/10.1510/icvts.2009.216861.

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35

Stecker, Michael S., and Chieh-Min Fan. "Lymphangiography for Thoracic Duct Interventions." Techniques in Vascular and Interventional Radiology 19, no. 4 (2016): 277–85. http://dx.doi.org/10.1053/j.tvir.2016.10.010.

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36

Rosique López, Lina, and Mariano Rosique Arias. "Thoracic Duct Cyst, Sclerosing Treatment." Acta Otorrinolaringologica (English Edition) 65, no. 3 (2014): 211–13. http://dx.doi.org/10.1016/j.otoeng.2014.05.015.

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37

Monkhouse, W. S., and R. K. S. Phillips. "WHO'S FOR THE THORACIC DUCT?" Lancet 332, no. 8615 (1988): 857–58. http://dx.doi.org/10.1016/s0140-6736(88)92828-0.

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38

Wilson, Kyle, Mamadou L. Sanogo, Samantha Kobeissi, et al. "Chylothorax and Thoracic Duct Embolization." Journal of Radiology Nursing 39, no. 1 (2020): 16–19. http://dx.doi.org/10.1016/j.jradnu.2019.12.008.

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39

Chen, Jonathan M. "The thoracic duct: Predictably unpredictable?" Journal of Thoracic and Cardiovascular Surgery 150, no. 3 (2015): 497. http://dx.doi.org/10.1016/j.jtcvs.2015.07.013.

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40

Kuyumcu, Gokhan, Robert Gordon, Harald Ott, and Suvranu Ganguli. "CT–Guided Thoracic Duct Embolization." Journal of Vascular and Interventional Radiology 27, no. 11 (2016): 1753–55. http://dx.doi.org/10.1016/j.jvir.2016.08.002.

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41

Hematti, Hamid, and Reza J. Mehran. "Anatomy of the Thoracic Duct." Thoracic Surgery Clinics 21, no. 2 (2011): 229–38. http://dx.doi.org/10.1016/j.thorsurg.2011.01.002.

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42

&NA;. "Cysts of the thoracic duct." Advances in Anatomic Pathology 7, no. 2 (2000): 130–31. http://dx.doi.org/10.1097/00125480-200007020-00014.

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43

Watanabe, Takuya, Masayuki Tanahashi, Eriko Suzuki, Naoko Yoshii, and Hiroshi Niwa. "A surgical case of thoracic duct cyst with preparation to identify the thoracic duct." Journal of the Japanese Association for Chest Surgery 34, no. 7 (2020): 728–32. http://dx.doi.org/10.2995/jacsurg.34.728.

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44

Drabkin, Michael, Majid Maybody, Nadia Solomon, Sirish Kishore, and Ernesto Santos. "Combined antegrade and retrograde thoracic duct embolization for complete transection of the thoracic duct." Radiology Case Reports 15, no. 7 (2020): 929–32. http://dx.doi.org/10.1016/j.radcr.2020.04.035.

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45

Nadolski, Gregory J., and Maxim Itkin. "Lymphangiography and thoracic duct embolization following unsuccessful thoracic duct ligation: Imaging findings and outcomes." Journal of Thoracic and Cardiovascular Surgery 156, no. 2 (2018): 838–43. http://dx.doi.org/10.1016/j.jtcvs.2018.02.109.

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46

Courtney, Malachi, and Raj R. Ayyagari. "Idiopathic chylopericardium treated by percutaneous thoracic duct embolization after failed surgical thoracic duct ligation." Pediatric Radiology 45, no. 6 (2014): 927–30. http://dx.doi.org/10.1007/s00247-014-3182-y.

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47

Hirano, Takaki, Masayoshi Yamamoto, Hiroshi Kondo, and Hiroshi Oba. "Thoracic duct disruption without lymphangiographic thoracic duct visualization for refractory chylothorax: A case report." Radiology Case Reports 19, no. 1 (2024): 242–45. http://dx.doi.org/10.1016/j.radcr.2023.09.097.

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48

Ryu, Somi, Byeong Min Lee, Seongjun Won, and Jung Je Park. "A Case Report on the Management of Intractable Chyle Leakage after Left Neck Level V Lymph Node Biopsy." Korean Journal of Otorhinolaryngology-Head and Neck Surgery 64, no. 2 (2021): 124–28. http://dx.doi.org/10.3342/kjorl-hns.2020.00087.

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Chyle leakage from the neck, which usually occurs after iatrogenic injury of the thoracic or lymphatic duct, is an uncommon complication of head and neck surgeries, which include neck dissection or thyroidectomy. A small amount of chyle leakage can be treated with conservative approaches, such as nutritional limitation, somatostatin analogues, and wound compression. However, massive or uncontrolled chyle leakage requires surgical exploration of the wound and thoracic duct ligation via the chest or transabdominal thoracic duct embolization can be applied. Here, we report a case of intractable m
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49

Padegaonkar, Amol, Anushree Sehgal, and Shambhunath Agrawal. "A rare case of abnormally high thoracic duct in neck." International Surgery Journal 8, no. 7 (2021): 2247. http://dx.doi.org/10.18203/2349-2902.isj20212750.

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Thoracic duct injury can be a cause of significant morbidity if its injury remain undiagnosed during surgery. Knowledge of its course and anomaly should be known to prevent its injury. Presenting a case of 40 year male who was diagnosed to have left buccal mucosa squamous cell carcinoma. During neck dissection, anomalous thoracic duct was found much above the omohyoid muscle. Adequate steps were taken to prevent injury to it. It is necessary to acknowledge thoracic duct and prevent its injury during neck dissection. Knowledge about its anomalous path should be known to prevent its injury. Vals
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Kapadia, Nandkishore, Saumya Sekhar Jenasamant, Ganesh Sohan Singh Rawat, Shailesh Kamkhedkar, Pratik Shah, and Parnal Kapadia. "Thoracic duct injury after decortication of lung, new technique to repair thoracic duct in this challenging situation: A case report." Asian Cardiovascular and Thoracic Annals 29, no. 6 (2021): 558–61. http://dx.doi.org/10.1177/0218492321997080.

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Background Chylothorax is a rare form of pleural effusion that can be associated with both traumatic and non-traumatic causes. Very few patients respond to conservative line of therapy. Thoracic duct ligation is often the treatment of choice in post-surgical patients; however, the optimal treatment of this disease process after traumatic injury remains unclear. Case presentation: We present the case of a 46-year-old woman with thoracic duct injury secondary to decortication for post-pneumonic empyema. Conservative therapy and pleurodesis done twice failed. She developed severe cachexia losing
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