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January 1964

Roentgenographic and Direct Visualization of Thoracic Duct

Author Affiliations

Postdoctoral Fellow of the National Science Foundation, 1963-1964 (Dr. Nusbaum); Clinical Fellow of the American Cancer Society, 1962-1963 (Dr. Hedges).; From the departments of surgery and radiology, The Graduate School of Medicine, The Graduate Hospital, and the Harrison Department of Surgical Research, Schools of Medicine, University of Pennsylvania.

Arch Surg. 1964;88(1):105-113. doi:10.1001/archsurg.1964.01310190107012

A method has been developed for the radiographic and direct visualization of the thoracic duct by modification of techniques of peripheral lymphangiography which can localize the site and nature of thoracic duct injury. By use of chlorophylized Ethiodol * preparations during peripheral lymphangiography, the thoracic duct can be stained light green, allowing for direct visualization at thoracotomy.

Animal studies utilizing these techniques and cinefluorographic monitoring of thoracic duct function are presented. Thoracic duct variations in patients studied are recorded, and two case reports will be presented in which lymphangiography was utilized to demonstrate the origin of chylous effusions.

Material and Methods  In the performance of more than 100 lymphangiograms in patients by Dr. Stanley Baum, the following technique was employed. An amount of 0.5 cc of equal parts of Evans blue and 1% procaine hydrochloride is injected intradermally into the web space of the great and second toes bilaterally. A small

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