thoracic duct


Summary: The largest lymphatic vessel that passes through the chest and drains into the SUBCLAVIAN VEIN.

Top Publications

  1. Kumar S, Kumar A, Pawar D. Thoracoscopic management of thoracic duct injury: Is there a place for conservatism?. J Postgrad Med. 2004;50:57-9 pubmed
    b>Thoracic duct injury is a rare but serious complication following chest surgeries and major neck dissections. Clinically, it can present as cervical chylous fistula, chylothorax or chylopericardium...
  2. Gerstein J, Kofahl Krause D, Frühauf J, Bremer M. Complete remission of a lymphoma-associated chylothorax by radiotherapy of the celiac trunk and thoracic duct. Strahlenther Onkol. 2008;184:484-7 pubmed publisher
    ..A chylothorax is a rare complication of mostly advanced malignant lymphomas. A case of a refractory chylothorax unresponsive to chemotherapy and successfully treated with radiotherapy is reported...
  3. Nakayama H, Ito H, Kato Y, Tsuboi M. Ultrasonic scalpel for sealing of the thoracic duct: evaluation of effectiveness in an animal model. Interact Cardiovasc Thorac Surg. 2009;9:399-401 pubmed publisher
    ..The whole length of thoracic duct of each pig was clearly imaged by pigment...
  4. Aerts N, Erling N, Fontes P. Thoracoscopic thoracic duct ligation for chylothorax after traumatic subclavian artery injury. J Thorac Cardiovasc Surg. 2006;131:752-3 pubmed
  5. De Santis M, Martins V, Fonseca A, Santos O. Large mediastinal thoracic duct cyst. Interact Cardiovasc Thorac Surg. 2010;10:138-9 pubmed publisher
    b>Thoracic duct cysts of the mediastinum are extremely rare. The etiology is related to a congenital or degenerative weakness in the wall of the thoracic duct. Symptoms may arise from compression of adjacent structures...
  6. Gottwald F, Iro H, Finke C, Zenk J. Thoracic duct cysts: a rare differential diagnosis. Otolaryngol Head Neck Surg. 2005;132:330-3 pubmed
    Cysts of the thoracic duct located in the supraclavicular region are uncommon. To date only 12 cases in this topographic area have been described in the literature...
  7. Cope C, Salem R, Kaiser L. Management of chylothorax by percutaneous catheterization and embolization of the thoracic duct: prospective trial. J Vasc Interv Radiol. 1999;10:1248-54 pubmed
    To prospectively assess the efficacy of percutaneous transabdominal thoracic duct catheterization and embolization in the management of patients with high-output chylothoracic effusions.
  8. Nepiyushchikh Z, Chakraborty S, Wang W, Davis M, Zawieja D, Muthuchamy M. Differential effects of myosin light chain kinase inhibition on contractility, force development and myosin light chain 20 phosphorylation of rat cervical and thoracic duct lymphatics. J Physiol. 2011;589:5415-29 pubmed publisher
    ..cervical lymphatics possess an inherently higher frequency but lower tone at a given pressure when compared to thoracic duct lymphatics...
  9. Thompson K, Kernstine K, Grannis F, Mojica P, Falabella A. Treatment of chylothorax by robotic thoracic duct ligation. Ann Thorac Surg. 2008;85:334-6 pubmed
    ..After left lower lobectomy, left-sided chylothorax developed. Conservative management failed, and a robotic right-sided thoracic duct ligation was performed. Other treatment options are reviewed.

More Information


  1. Parikh K, Witte M, Samson R, Teodori M, Carpenter J, Lowe M, et al. Successful treatment of plastic bronchitis with low fat diet and subsequent thoracic duct ligation in child with fontan physiology. Lymphology. 2012;45:47-52 pubmed
    ..We report an 11 year old boy who developed severe plastic bronchitis following Fontan repair and the successful long-term control of cast formation utilizing a low-fat diet and subsequent thoracic duct ligation.
  2. Cleland L, Wing S, Spargo L, Mayrhofer G. Temporal changes in the distribution of thoracic duct lymphoblasts to synovium and other tissues of rats with adjuvant-induced arthritis. Immunol Cell Biol. 2002;80:148-55 pubmed
    ..b>Thoracic duct lymphoblasts labelled in vitro with [125I]-iododeoxyuridine were detected in recipient rats by external ..
  3. Arstila T, Arstila T, Calbo S, Selz F, Malassis Seris M, Vassalli P, et al. Identical T cell clones are located within the mouse gut epithelium and lamina propia and circulate in the thoracic duct lymph. J Exp Med. 2000;191:823-34 pubmed
    ..identical T cell clones were detected among CD8alpha/beta IELs and CD8alpha/beta+ blasts circulating into the thoracic duct (TD) lymph of the same mouse, whereas TD small lymphocytes are polyclonal...
  4. Knott E, Tune J, Stoll S, Downey H. Increased lymphatic flow in the thoracic duct during manipulative intervention. J Am Osteopath Assoc. 2005;105:447-56 pubmed
    ..The authors surgically instrumented five mongrel dogs to record lymphatic flow in the thoracic duct (TDF) and cardiac variables during three intervention protocols...
  5. Cope C, Kaiser L. Management of unremitting chylothorax by percutaneous embolization and blockage of retroperitoneal lymphatic vessels in 42 patients. J Vasc Interv Radiol. 2002;13:1139-48 pubmed
    ..To demonstrate the applicability, technique, and efficacy of percutaneous transabdominal catheter embolization or needle disruption of retroperitoneal lymphatic vessels in the treatment of high-output or unremitting chylothorax...
  6. Binkert C, Yucel E, Davison B, Sugarbaker D, Baum R. Percutaneous treatment of high-output chylothorax with embolization or needle disruption technique. J Vasc Interv Radiol. 2005;16:1257-62 pubmed
    Surgical ligation of the thoracic duct is associated with a high degree of morbidity; therefore, a minimally invasive approach is desirable. Herein, eight percutaneously treated patients are described...
  7. Shah S, Drinkwater D, Christian K. Plastic bronchitis: is thoracic duct ligation a real surgical option?. Ann Thorac Surg. 2006;81:2281-3 pubmed
    ..normal Fontan pressures on cardiac catheterization, we decided to explore a surgical solution by performing a thoracic duct ligation...
  8. Hayashi K, Sicard G, Gellasch K, Frank J, Hardie R, McAnulty J. Cisterna chyli ablation with thoracic duct ligation for chylothorax: results in eight dogs. Vet Surg. 2005;34:519-23 pubmed
    To report use of combined cisterna chyli ablation (CCA) and thoracic duct ligation (TDL) for treatment of spontaneously occurring chylothorax in dogs.
  9. Guo W, Zhao Y, Jiang Y, Niu H, Liu X, Ma Z, et al. Prevention of postoperative chylothorax with thoracic duct ligation during video-assisted thoracoscopic esophagectomy for cancer. Surg Endosc. 2012;26:1332-6 pubmed publisher
    ..In this retrospective series, we evaluated the results of preventive intraoperative thoracic duct ligation in patients who underwent video-assisted thoracoscopic esophagectomy for cancer.
  10. Telinius N, Drewsen N, Pilegaard H, Kold Petersen H, de Leval M, Aalkjaer C, et al. Human thoracic duct in vitro: diameter-tension properties, spontaneous and evoked contractile activity. Am J Physiol Heart Circ Physiol. 2010;299:H811-8 pubmed publisher
    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...
  11. Ionac M. One technique, two approaches, and results: thoracic duct cannulation in small laboratory animals. Microsurgery. 2003;23:239-45 pubmed
    Experimental studies in immunology, pharmacology, or hematology require the sampling of the total thoracic duct lymph in awake and unrestrained rats or mice...
  12. van Goor A, Kroger R, Klomp H, de Jong M, van den Brekel M, Balm A. Introduction of lymphangiography and percutaneous embolization of the thoracic duct in a stepwise approach to the management of chylous fistulas. Head Neck. 2007;29:1017-23 pubmed
    ..This article reports on percutaneous embolization of the thoracic duct through catheterization of the retroperitoneal lymph vessels.
  13. Carobbi B, White R, Romanelli G. Treatment of idiopathic chylothorax in 14 dogs by ligation of the thoracic duct and partial pericardiectomy. Vet Rec. 2008;163:743-5 pubmed
    The outcome and complications associated with thoracic duct ligation combined with partial pericardiectomy in 14 dogs with idiopathic chylothorax were investigated retrospectively...
  14. Le Pimpec Barthes F, Pham M, Jouan J, Bel A, Fabiani J, Riquet M. Peritoneoatrial shunting for intractable chylous ascites complicating thoracic duct ligation. Ann Thorac Surg. 2009;87:1601-3 pubmed publisher
    b>Thoracic duct ligation for chylothorax is considered a safe and efficient procedure. However, we observed two cases that were complicated by intractable chylous ascites...
  15. Allman D, Radlinsky M, Ralph A, Rawlings C. Thoracoscopic thoracic duct ligation and thoracoscopic pericardectomy for treatment of chylothorax in dogs. Vet Surg. 2010;39:21-7 pubmed publisher
    To report the use of thoracoscopic thoracic duct ligation (TDL) and pericardectomy for treatment of chylothorax.
  16. Kim M, Lee H, Lee N, Choi M, Kim J, Chang D, et al. Ultrasound-guided mesenteric lymph node iohexol injection for thoracic duct computed tomographic lymphography in cats. Vet Radiol Ultrasound. 2011;52:302-5 pubmed publisher
    ..The thoracic duct and its branches were clearly delineated in CT images of seven cats studied...
  17. Gunnlaugsson C, Iannettoni M, Yu B, Chepeha D, Teknos T. Management of chyle fistula utilizing thoracoscopic ligation of the thoracic duct. ORL J Otorhinolaryngol Relat Spec. 2004;66:148-54 pubmed
    To document the treatment of refractory chyle leaks using thoracoscopic thoracic duct ligation and provide systematic guidelines to manage chyle leaks.
  18. Gashev A, Davis M, Zawieja D. Inhibition of the active lymph pump by flow in rat mesenteric lymphatics and thoracic duct. J Physiol. 2002;540:1023-37 pubmed
    ..Imposed flow inhibited the active lymph pump in both mesenteric lymphatics and in the thoracic duct. The active pump of the thoracic duct appeared more sensitive to flow than did the active pump of the ..
  19. Lemaire L, van Wagensveld B, van Gulik T, Dankert J, van Lanschot J, Gouma D. Bacterial translocation to the thoracic duct in a setting of ischemia, partial resection and reperfusion of the porcine liver. Dig Surg. 1999;16:222-8 pubmed
    ..We investigated whether bacterial translocation occurs beyond the MLNs into the thoracic duct in a setting of ischemia, partial resection and reperfusion of the porcine liver.
  20. Stoll S, Bartsch S, Kroll J. HOXC9 regulates formation of parachordal lymphangioplasts and the thoracic duct in zebrafish via stabilin 2. PLoS ONE. 2013;8:e58311 pubmed publisher
    ..Morpholino-based expression silencing of HOXC9 repressed parachordal lymphangioblast assembly and thoracic duct formation in zebrafish...
  21. Stringel G, Teixeira J. Thoracoscopic ligation of the thoracic duct. JSLS. 2000;4:239-42 pubmed
    When nonoperative treatment of chylothorax fails, thoracic duct ligation is usually performed through a thoracotomy...
  22. Patel N, Lewandowski R, Bove M, Nemcek A, Salem R. Thoracic duct embolization: a new treatment for massive leak after neck dissection. Laryngoscope. 2008;118:680-3 pubmed publisher
    Chylothorax results from injury to the thoracic duct or one of its branches. It is an uncommon but possibly serious complication of thoracic or head and neck surgery...
  23. Schild H, Hirner A. Percutaneous translymphatic thoracic duct embolization for treatment of chylothorax. Rofo. 2001;173:580-2 pubmed
    A modified technique for transabdominal, translymphatic occlusion of the thoracic duct is described...
  24. Hodge L, King H, Williams A, Reder S, Belavadi T, Simecka J, et al. Abdominal lymphatic pump treatment increases leukocyte count and flux in thoracic duct lymph. Lymphat Res Biol. 2007;5:127-33 pubmed
    ..In this study, the thoracic duct of eight anesthetized mongrel dogs was catheterized, so the immediate effects of LPT on lymph flow and ..
  25. Itkin M, Kucharczuk J, Kwak A, Trerotola S, Kaiser L. Nonoperative thoracic duct embolization for traumatic thoracic duct leak: experience in 109 patients. J Thorac Cardiovasc Surg. 2010;139:584-89; discussion 589-90 pubmed publisher
    ..To demonstrate the efficacy of a minimally invasive, nonoperative, catheter-based approach to the treatment of traumatic chyle leak...
  26. Petrenko V, Kruglov S. [Thoracic duct valves in man and albino rat]. Morfologiia. 2004;126:40-2 pubmed
    ..The aim of this research was to determine the number, structure and position of valves along the whole length of thoracic duct in man and albino rat...
  27. Nadolski G, Itkin M. Thoracic duct embolization for nontraumatic chylous effusion: experience in 34 patients. Chest. 2013;143:158-163 pubmed publisher
    b>Thoracic duct embolization (TDE) is an acceptable alternative procedure for treating traumatic chylothorax. The purpose of this study is to demonstrate efficacy of TDE in treating nontraumatic chylous effusions.
  28. Schumacher G, Weidemann H, Langrehr J, Jonas S, Mittler J, Jacob D, et al. Transabdominal ligation of the thoracic duct as treatment of choice for postoperative chylothorax after esophagectomy. Dis Esophagus. 2007;20:19-23 pubmed
    Postoperative chylothorax after injury of the thoracic duct during esophagectomy is a rare but severe complication which may lead to serious problems such as loss of fat and proteins, and immunodeficiency...
  29. Mittleider D, Dykes T, Cicuto K, Amberson S, Leusner C. Retrograde cannulation of the thoracic duct and embolization of the cisterna chyli in the treatment of chylous ascites. J Vasc Interv Radiol. 2008;19:285-90 pubmed publisher
    ..After the failure of conventional percutaneous direct cisterna chyli cannulation, the authors accessed the thoracic duct directly from the subclavian vein...
  30. Spargo L, Cleland L, Wing S, Hawkes J, Mayrhofer G. Characterization of thoracic duct cells that transfer polyarthritis. Clin Exp Immunol. 2001;126:560-9 pubmed
    ..distribution of arthritogenic effector lymphocytes that emerge in the efferent lymph and pass through the thoracic duct (TD) to the circulation...
  31. Pêgo Fernandes P, Jatene F, Tokunaga C, Simão D, Beirutty R, Iwahashi E, et al. Ligation of the thoracic duct for the treatment of chylothorax in heart diseases. Arq Bras Cardiol. 2003;81:309-17 pubmed
    ..We report 4 cases of chylothorax in patients who were successfully treated with this approach, which resulted in a decrease in pleural drainage without recurrent chylothorax...
  32. Ammar K, Tubbs R, Smyth M, Wellons J, Blount J, Salter G, et al. Anatomic landmarks for the cervical portion of the thoracic duct. Neurosurgery. 2003;53:1385-7; discussion 1387-8 pubmed
    Avoidance of injury to the thoracic duct during neurosurgical procedures involving the cervical region depends on a working knowledge of its location...
  33. Fossum T, Mertens M, Miller M, Peacock J, Saunders A, Gordon S, et al. Thoracic duct ligation and pericardectomy for treatment of idiopathic chylothorax. J Vet Intern Med. 2004;18:307-10 pubmed
    ..abnormal venous pressures would act to impede the drainage of chyle via lymphaticovenous communications after thoracic duct (TD) ligation...
  34. Nadolski G, Itkin M. Feasibility of ultrasound-guided intranodal lymphangiogram for thoracic duct embolization. J Vasc Interv Radiol. 2012;23:613-6 pubmed publisher
    To show the feasibility of opacifying the thoracic duct using ultrasound-guided intranodal lymphangiogram (IL) for thoracic duct embolization (TDE).
  35. Valentine C, Barresi R, Prinz R. Somatostatin analog treatment of a cervical thoracic duct fistula. Head Neck. 2002;24:810-3 pubmed
    Reoperation for recurrent thyroid cancer poses an increased risk of complications, including thoracic duct fistula. Treatment of this complication is controversial...
  36. Stewart K, Padgett S. Chylothorax treated via thoracic duct ligation and omentalization. J Am Anim Hosp Assoc. 2010;46:312-7 pubmed
    ..All animals received thoracic duct ligation and thoracic omentalization...
  37. BOLLMAN J, Cain J, GRINDLAY J. Techniques for the collection of lymph from the liver, small intestine, or thoracic duct of the rat. J Lab Clin Med. 1948;33:1349-52 pubmed
  38. Ashitate Y, Tanaka E, STOCKDALE A, Choi H, Frangioni J. Near-infrared fluorescence imaging of thoracic duct anatomy and function in open surgery and video-assisted thoracic surgery. J Thorac Cardiovasc Surg. 2011;142:31-8.e1-2 pubmed publisher
    Chylothorax resulting from thoracic duct damage is often difficult to identify and repair...
  39. Matsuo M, Koizumi K, Yamada S, Tomi M, Takahashi R, Ueda M, et al. Establishment and characterization of conditionally immortalized endothelial cell lines from the thoracic duct and inferior vena cava of tsA58/EGFP double-transgenic rats. Cell Tissue Res. 2006;326:749-58 pubmed
    ..The cloned cell lines were named TR-LE (temperature-sensitive rat lymphatic endothelial cells from thoracic duct) and TR-BE (temperature-sensitive rat blood-vessel endothelial cells from inferior vena cava), respectively, ..
  40. Nath D, Savla J, Khemani R, Nussbaum D, Greene C, Wells W. Thoracic duct ligation for persistent chylothorax after pediatric cardiothoracic surgery. Ann Thorac Surg. 2009;88:246-51; discussion 251-2 pubmed publisher
    There is considerable literature on incidence and medical management of postsurgical chylothorax in children but little is known about outcomes of thoracic duct ligation (TDL) for patients refractory to medical therapy.
  41. Buchan K, Hosseinpour A, Ritchie A. Thoracoscopic thoracic duct ligation for traumatic chylothorax. Ann Thorac Surg. 2001;72:1366-7 pubmed
    ..This usually entails thoracotomy or laparotomy. We report a case in which successful ligation of a torn thoracic duct was achieved using a video-assisted thoracoscopic technique.
  42. Christodoulou M, Ris H, Pezzetta E. Video-assisted right supradiaphragmatic thoracic duct ligation for non-traumatic recurrent chylothorax. Eur J Cardiothorac Surg. 2006;29:810-4 pubmed
    ..We report our experience with video-assisted right-sided supradiaphragmatic thoracic duct ligation for non-traumatic, non-postoperative persistent or recurrent chylothorax.
  43. Hayden J, Sue Ling H, Sarela A, Dexter S. Minimally invasive management of chylous fistula after esophagectomy. Dis Esophagus. 2007;20:251-5 pubmed
    ..Open surgery may be appropriate where minimally invasive approaches fail or where the availability of such skills is limited...
  44. Li Y, Wang J, Li Y, Lin Z. A modified rat model for cannulation and collection of thoracic duct lymph. Lymphology. 2011;44:82-8 pubmed
    ..Here we report a simple and effective modified rat model for thoracic duct lymph drainage where animals remain in full consciousness and have free movement and access to water and food ..
  45. Vaughan J, Fox R, Abresch R, Tsoukas C, Curd J, Carson D. Thoracic duct drainage in rheumatoid arthritis. Clin Exp Immunol. 1984;58:645-53 pubmed
    b>Thoracic duct drainage (TDD) led to major improvement of disease in two of five patients with severe rheumatoid arthritis and lesser improvement in two others...
  46. Raco A, Russo N, Landi A, Dazzi M, Carlesimo B. Lymphatic fluid fistula: an extremely rare complication of posterior lumbar transpedicular screw fixation. Case report. J Neurosurg Spine. 2006;4:421-3 pubmed
  47. Banno F, Doisaki S, Shimizu N, Fujimoto K. Lymphatic absorption of docosahexaenoic acid given as monoglyceride, diglyceride, triglyceride, and ethyl ester in rats. J Nutr Sci Vitaminol (Tokyo). 2002;48:30-5 pubmed
    ..Furthermore, the intramolecular distribution of DHA in lymph TG was similar in all groups. docosahexaenoic acid, monoglyceride, diglyceride triglyceride, ethyl ester ..
  48. Moran J, Bocage J, Caccavale R. Resection of a thoracic duct lymphangioma using video-assisted thoracoscopic surgery. Ann Thorac Surg. 2005;79:1052-4 pubmed
    b>Thoracic duct lymphangioma is a rare mediastinal tumor. Most patients are asymptomatic. Symptoms may include dysphagia, dyspnea, cough, or chest pain. Workup may include chest computed tomography or lymphangiography, or both...
  49. Shirouchi B, Kawamura S, Matsuoka R, Baba S, Nagata K, Shiratake S, et al. Dietary guar gum reduces lymph flow and diminishes lipid transport in thoracic duct-cannulated rats. Lipids. 2011;46:789-93 pubmed publisher
    ..We propose that dietary guar gum reduces lymph flow and thereby diminishes lipid transport by means of its physicochemical properties related to water behavior in the intestine. ..
  50. Aleksandrovych V, Walocha J, Gil K. Telocytes in female reproductive system (human and animal). J Cell Mol Med. 2016;20:994-1000 pubmed publisher
    ..female reproductive system (uterus, Fallopian tube, placenta, mammary gland); vasculature (blood vessels, thoracic duct); serous membranes (mesentery and pleura); and other organs (skeletal muscle, meninges and choroid plexus, ..
  51. Mager H, Maesen B, Verzijlbergen F, Schramel F. Distribution of talc suspension during treatment of malignant pleural effusion with talc pleurodesis. Lung Cancer. 2002;36:77-81 pubmed
    ..Standard rotation protocols for patients with malignant pleural effusion do not affect the overall dispersion of talc suspension and should be abolished because of the discomfort caused to the patients. ..
  52. Trumpa M, Stephan I, Baumgartner W, Nolte I. [Case report. Restrictive cardiomyopathy with chylothorax in a cat: the pathogenesis]. Dtsch Tierarztl Wochenschr. 2004;111:438-42 pubmed
    ..The coherence between feline cardiopathy and chylothorax was discussed speculatively in previous reports. In this report we show a possible aetiopathology. ..
  53. Witte M, Williams W. Chylothorax and chyloperitoneum. N Engl J Med. 2006;354:879; author reply 879 pubmed
  54. Novitzky D, Guglin M. Chylopericardium presenting with tamponade and cardiogenic shock. J Card Surg. 2010;25:522-4 pubmed publisher
    ..After the initial pericardial drainage and failed conservative treatment, thoracic duct ligation was performed with good long-term outcome. Literature on the subject is reviewed.
  55. Adhikesavan L, Ayoub W, Schumacher H. Misdiagnosis of a chylous cyst as chest wall gouty tophus: a case of true pseudogout. Arthritis Rheum. 2007;56:3854-7 pubmed
    ..Chylous cysts of the neck or chest wall can be caused by thoracic duct injury...
  56. Puri B, Gunatilake K, Fernando K, Gurusinghe A, Agour M, Treasaden I. Increased tenderness in the left third intercostal space in adult patients with myalgic encephalomyelitis: a controlled study. J Int Med Res. 2011;39:212-4 pubmed
    ..This finding may be related to changes in lymphatic function and to the descending course of the thoracic duct. Further studies, preferably blinded and combined with appropriate imaging, are required.
  57. Kumasaka T, Seyama K, Mitani K, Souma S, Kashiwagi S, Hebisawa A, et al. Lymphangiogenesis-mediated shedding of LAM cell clusters as a mechanism for dissemination in lymphangioleiomyomatosis. Am J Surg Pathol. 2005;29:1356-66 pubmed
    ..effusion and 2 ascites), surgically resected diaphragm (1 patient), and axial lymphatic system including the thoracic duct, lymph nodes at various regions, and diaphragmatic lymphatic system (5 autopsy cases)...
  58. Erden A. Cisterna chyli: an incidental finding on MR cholangiopancreatography. AJR Am J Roentgenol. 2004;182:262 pubmed
  59. Ikeda I, Yamahira T, Kato M, Ishikawa A. Black-tea polyphenols decrease micellar solubility of cholesterol in vitro and intestinal absorption of cholesterol in rats. J Agric Food Chem. 2010;58:8591-5 pubmed publisher
    ..lymphatic recovery of both (3)H-cholesterol and (14)C-trioleoylglycerol in rats that were cannulated in the thoracic duct. BTP decreased the in vitro micellar solubility of cholesterol in a dose-dependent manner...
  60. Kumar A, Bin Asaf B, Chugh K, Talwar N. Thoracoscopic ligation of thoracic duct for spontaneous chylothorax. Indian Pediatr. 2013;50:796-8 pubmed
    ..We present a case of left sided spontaneous chylothorax in a 20-month-old boy. We report successful management of this difficult problem with thoracoscopic ligation of thoracic duct after a failed trial with conservative management.
  61. Huang X, Wu J, Ferrando R, Lee J, Wang Y, Farese R, et al. Fatal bilateral chylothorax in mice lacking the integrin alpha9beta1. Mol Cell Biol. 2000;20:5208-15 pubmed
    ..alpha9 protein is transiently expressed in the developing thoracic duct at embryonic day 14, but expression is rapidly lost during later stages of development...