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October 1946

INJURIES OF THE THORACIC DUCT: Report of a Case of Chylothorax in Which the Patient Recovered After Ligation of the Thoracic Duct

Arch Surg. 1946;53(4):448-455. doi:10.1001/archsurg.1946.01230060456009

CHYLOTHORAX due to damage of the thoracic duct either in the neck or in the chest is of rare occurrence and carries a high mortality. The continuous loss of chyle, without replacement, results fatally. Shackelford and Fisher1 in 1938 summarized the findings in 41 completely recorded cases collected up to that time. Seven additional cases were not included in their statistical study, because of insufficient data. The mortality was 47.5 per cent. Bauersfeld2 in 1937 could find only 6 cases reported from this country. Dorsey and Morris3 in 1943 added 12 more cases, bringing the total to 60, and in 1945 Florer and Ochsner4 reported another; including the case reported in this paper, the total is in the neighborhood of 62.

While chylothorax is of rare occurrence, severance of the thoracic duct in the neck without chylothorax is not uncommon. On one occasion, I deliberately ligated

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