A review of the surgery of the thoracic duct.

If a moment in time can ever be said to mark the beginning of interest in a subject, in this instance it must have been in 1622 when Gasparo Aselli pricked a lacteal in a dog's mesentery and saw the chyle come out. Possibly because it is seldom seen, and because it manifests its importance only when damaged and leaking, the thoracic duct has an aura of mystery. The problem of a chylous effusion in the pleural cavity is not a common one, but it tends to occur when least expected, and a definite plan of action, of necessity often based on the experience of others, must be available to meet the situation when it arises. Further, with the increasing incidence both of chest injury associated with modern travel, and of surgical procedures involving the thoracic contents and vertebral column, chylothorax may well be met