Background: The thoracic duct plays an important role in fluid balance, lipid absorption, and transport of immunologically active cells. The thoracic duct is difficult to access but is readily identified by EUS. The present study assessed the feasibility of EUS identification and EUS-guided puncture of the thoracic duct in a swine model.
Methods: Transesophageal EUS-guided thoracic duct puncture was attempted in 3 animals under fluoroscopy. In two animals, the thoracic duct was identified by cutdown in the neck; in the third animal, EUS-guided puncture was performed under fluoroscopy alone. In one animal, the thoracic duct was opacified by injecting contrast medium. In the second animal, thoracic duct was injected with patent blue and contrast medium.
Observations: Thoracic duct was identified and punctured successfully in all 3 animals. In the first animal, contrast medium containing lymph was aspirated. In the second animal, lymph containing patent blue was aspirated, and, in the third animal, successful puncture was confirmed by obtaining a lymphangiogram.
Conclusions: This pilot study in an animal model demonstrates that transesophageal EUS-guided puncture of the thoracic duct is feasible and that the technique can be used for lymph sampling and/or lymphangiography.
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http://dx.doi.org/10.1016/s0016-5107(03)02880-3 | DOI Listing |
BJS Open
December 2024
Department of Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands.
Background: Patients with painful chronic pancreatitis combined with a dilated main pancreatic duct and a normal size pancreatic head are treated according to guidelines by lateral pancreaticojejunostomy (LPJ). This systematic review compared outcomes of minimally invasive LPJ and open LPJ.
Methods: From 1 January 2000 until 13 November 2023, series reporting on minimally invasive LPJ and open LPJ in patients with symptomatic chronic pancreatitis were included.
J Thorac Dis
December 2024
Lymphatic Surgery Department, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China.
Background: Chylopericardium is a rare disease resulting from lymphatic system dysfunction and characterized by recurrent chylous pericardial effusion and cardiac compression. Traditional treatments like fasting, somatostatin injection and ligation of pericardial lymphatic vessels are less effective, with high recurrence rate. Fenestration is regarded as the last resort for treating chylopericardium.
View Article and Find Full Text PDFJ Thorac Dis
December 2024
Department of Thoracic Surgery, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China.
Background: Chylothorax following esophagectomy is a frustrating complication with considerable morbidity. In addition, recognizing the morphological patterns of the thoracic duct (TD) holds great significance. This study was aimed at explore the safety and efficacy of three-dimensional (3D) thoracoscope in comparison with indocyanine green (ICG) fluorescence to identify TD during minimally invasive esophagectomy (MIE) for esophageal cancer.
View Article and Find Full Text PDFRev Med Liege
January 2025
Service de Médecine nucléaire et Imagerie.
Spontaneous cervical swelling syndrome is a rare, benign, and recurrent condition, most commonly affecting middle-aged women. Although its etiology is not fully understood, it is thought to be associated with intermittent occlusion of the thoracic duct, caused by increased pressure in the head and neck region. It occurs as an acute, limited swelling of the left supra-clavicular region and regresses, in most cases, spontaneously, in less than a week.
View Article and Find Full Text PDFRadiol Case Rep
March 2025
Faculty of Medicine, Arab American University of Palestine, Jenin, Palestine.
Spontaneous cervical swelling syndrome is an uncommon clinical syndrome characterized by the sudden onset of swelling in the cervical region with no identifiable cause. A 47-year-old woman with a history of Iron Deficiency Anemia presented to the emergency department (ED) complaining of an acute left neck and upper chest swelling and pressure sensation in her neck. The swelling started suddenly and was growing rapidly over several hours.
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