THORACIC DUCT (ductus thoracicus)

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posterior part of thoracic cage is drained. The length of the 
thoracic duct is 30–40 cm and its diameter is 2 – 4 mm. Over the 
total length of thoracic duct there are the following valves: one is 
above the diaphragm, 1 – 2 are located at the level of aortic arch, 
1 – 2 are located in the cervical part. The thoracic duct is formed in 
the the retroperitoneal space by joining of right and left lumbar 
trunks (truncus lumbalis dexter et sinister) at the level of the 12th 
thoracic vertebra and the 2nd lumbar vertebra to the right from 
aorta.
The initial part of thoracic duct has the dilatation (cisterna 
chyli). To the posterior mediastinum the lymphatic duct goes 
through the aortic hiatus and passes on the anterior surface of 
vertebra between the descending part of aorta and azygos 
vein behind esophagus. There are right posterior intercostal 
arteries, hemiazygos vein and additional hemiazygos vein 
behind the thoracic duct.
There is esophagus and n. vagus anteriorly. From the right 
the thoracic duct is covered with mediastinal pleura and can 
be damaged. The dextral chylothorax occurs. Daily long-term 
loss of several liters of lymph leads to cachexia and that is why 
in thoracic duct damage it is necessary to ligate it. After 
ligation of thoracic duct the lymph is drained through bypath.
At the level of the 5th thoracic vertebra the thoracic duct 
shift to the left and up, passes behind aortic arch and a. carotis 
communis sinistra, n. vagus and v. jugularis interna, anteriorly 
from a. et v. vertebralis it is attached to the cupula of the 
pleura forming the arch and turning a. subclavia. It drains into 
the left venous angle which is formed by v. jugularis interna 
and v. subclavia.

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