Thoracic duct injury

Thoracic duct injury

Wounds to the thoracic duct are usually iatrogenic and usually left sided, occurring when lymph node level IV is dissected during a neck dissection. When damage to the duct is not leak from the wound in amounts up to 2 /uni00A0 L/day with profound e ff ects on nutrition. Should the damage be recognised during an operation, the proximal end of the duct must be ligated. Ligation of the duct is not harmful because there are a number of anastomotic chan nels betw een the lymphatic and venous systems in the lower neck. If undetected, chyle usually starts to discharge from the neck wound within 24 hours of the operation. Low-flow chyle leaks (less than 500 /uni00A0 mL/day) can be managed conserv atively with a low-fat diet and systemic octreotide. The patient’s fluid and electrolyte balance must be closely monitored. Total par enteral nutrition and surgical re-exploration may be warranted in high-output leaks. Thoracic duct injury

Wounds to the thoracic duct are usually iatrogenic and usually left sided, occurring when lymph node level IV is dissected during a neck dissection. When damage to the duct is not leak from the wound in amounts up to 2 /uni00A0 L/day with profound e ff ects on nutrition. Should the damage be recognised during an operation, the proximal end of the duct must be ligated. Ligation of the duct is not harmful because there are a number of anastomotic chan nels betw een the lymphatic and venous systems in the lower neck. If undetected, chyle usually starts to discharge from the neck wound within 24 hours of the operation. Low-flow chyle leaks (less than 500 /uni00A0 mL/day) can be managed conserv atively with a low-fat diet and systemic octreotide. The patient’s fluid and electrolyte balance must be closely monitored. Total par enteral nutrition and surgical re-exploration may be warranted in high-output leaks.