Vessel
Thoracic duct
The main lymphatic return route through the chest
High-yield
It usually serves the body below the diaphragm and the left upper body. A cisterna chyli and a single opening exactly at the left venous angle are not universal findings.
Overview
Lymph from abdominal and lower-body channels ascends through the thorax in the thoracic duct. Its usual path starts on the right of the lower posterior mediastinum, crosses leftward and ends among veins at the left neck base.
Reference facts
- Origin
- Abdominal lymphatic channels, often with a cisterna chyli receiving lumbar and intestinal tributaries
- Course
- Through the aortic hiatus near T12, behind the esophagus, then leftward around the mid-thoracic region and into the root of the neck
- Branches
- Incoming lumbar, intestinal and thoracic tributaries; left jugular, subclavian and bronchomediastinal trunks may join near its end
- Drains to
- Usually a left cervical vein near the internal jugular–subclavian junction; the precise vessel and number of openings vary
Mnemonic
Usual route: abdomen, right chest, leftward crossing, neck veins.
Clinical correlation
Duct injury can leak chyle into the pleural space. Chylothorax is not always milky, so fluid appearance alone cannot exclude it.
Frequently asked questions
Where does the thoracic duct originate?
The thoracic duct arises from the abdominal lymphatic channels, often with a cisterna chyli receiving lumbar and intestinal tributaries.
Where does the thoracic duct drain to?
Usually a left cervical vein near the internal jugular–subclavian junction; the precise vessel and number of openings vary.
What are the tributaries of the thoracic duct?
Incoming lumbar, intestinal and thoracic tributaries; left jugular, subclavian and bronchomediastinal trunks may join near its end.
What is the course of the thoracic duct?
Through the aortic hiatus near T12, behind the esophagus, then leftward around the mid-thoracic region and into the root of the neck.