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The transient occlusion of the terminal thoracic duct is a rare disease responsible for renitent supraclavicular cysts. The aim of this study was to describe the clinical characteristics, evolution, and treatment.A retrospective multicenter study and literature review was carried out. The literature search (PubMed) was conducted including data up to 31 December 2020 and PRISMA guidelines were respected.This study identified 6 observational cases between September 2010 and December 2020. The search results indicated a total of 24 articles of which 19 were excluded due to the lack of recurrent swelling or the unavailability of full texts (n = 5). Fourteen patients (8 from literature) mostly reported a noninflammatory, painless renitent mass in the supraclavicular fossa which appeared rapidly over a few hours and disappeared spontaneously over an average of 8 days (range: from about 2 hours to 10 days). Anamnesis indicated a high-fat intake during the preceding days in all cases and 7 from literature found in the Medline databases. Recurrences were noted in 10 patients. Thoracic duct imaging was performed in all cases to detect abnormalities or extrinsic compression as well as to eliminate differential diagnoses.A painless, fluctuating, noninflammatory, and recurrent swelling of the left supraclavicular fossa in patients evoking an intermittent obstruction of the terminal portion of the thoracic duct was identified. A low-fat diet was found as safe and effective treatment.
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http://dx.doi.org/10.1097/MD.0000000000028213 | DOI Listing |
Interv Radiol (Higashimatsuyama)
July 2025
Department of Diagnostic Radiology, Institute of Science Tokyo, Japan.
Thoracic duct embolization has emerged as an alternative treatment for refractory chylothorax, in addition to thoracic duct ligation. Thoracic duct embolization is typically performed via direct puncture of the cisterna chyli and cannulation of the thoracic duct, or via a retrograde approach to the thoracic duct through the venous angle. The former requires a long puncture through abdominal organs; the latter has anatomical limitations depending on the case.
View Article and Find Full Text PDFSurg Oncol
September 2025
Department of Gastrointestinal Surgery, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Background: Recently, thoracic duct embolization (TDE) has been increasingly adopted as a first-line minimally invasive therapy for post-esophagectomy chylothorax instead of thoracoscopic thoracic duct ligation (TTDL). However, the therapeutic efficacy and advantages of TDE over TTDL are still controversial. This study aimed to evaluate and compare the clinical and financial outcomes of TDE and TTDL for post-operative chylothorax after esophagectomy using a national database.
View Article and Find Full Text PDFJBJS Case Connect
July 2025
Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India.
Case: A 12-year-old girl with neurofibromatosis type 1 presented with progressive thoracic scoliosis and neurological deficit. Imaging revealed a dystrophic curve, dorsal syrinx, and tethering of the cord by a plexiform neurofibroma arising from the T7 dorsal ramus. She underwent staged surgery: detethering through T6-T8 laminectomy, followed by posterior spinal deformity correction with Schwab type 2 osteotomies and instrumentation.
View Article and Find Full Text PDFCirc Cardiovasc Interv
September 2025
Division of Cardiology (Y.D., E.P., L.B., M.J.G., R.C., J.T., M.L.O.B., D.V., A.G.D.W., E.F., R.S., J.J.R., C.L.S.), Children's Hospital of Philadelphia, PA.
Background: External drainage of the thoracic duct can temporarily reduce tissue congestion and improve symptoms in patients with heart failure. However, loss of fluid limits the duration of this approach. Here, we report on our initial experience with thoracic duct drainage and autotransfusion in patients with elevated central venous pressure.
View Article and Find Full Text PDFAnn Med Surg (Lond)
September 2025
Vinmec Times City International Hospital, Hanoi, Vietnam.
Introduction And Importance: Chylous ascites is an exceptionally rare condition during pregnancy, typically presenting with nonspecific symptoms. To date, only a limited number of cases have been reported in the literature, and the majority of which occurred in singleton pregnancies.
Case Presentation: We report the case of a 25-year-old woman with a twin pregnancy who was admitted at 32 weeks of gestation with acute abdominal pain and nausea.