Thoracic duct

In human anatomy, the thoracic duct is the largest lymphatic vessel of the lymphatic system. It is also known as the left lymphatic duct, alimentary duct, chyliferous duct, and Van Hoorne's canal. It carries chyle, a liquid containing both lymph and emulsified fats, rather than pure lymph. Thus when it ruptures, the resulting flood of liquid into the pleural cavity is known as chylothorax.

In adults, the thoracic duct is typically 38–45 cm in length and has an average diameter of about 5 mm. The vessel usually starts from the level of the twelfth thoracic vertebrae (T12) and extends to the root of the neck. It drains into the systemic (blood) circulation at the left subclavian vein. It also collects most of the lymph in the body other than from the right thorax, arm, head and neck which are drained by the right lymphatic duct.

Structure

The lymph duct originates in the abdomen from the confluence of the right and left lumbar trunks and the intestinal trunk, forming a significant pathway upward called the cisterna chyli. It traverses the diaphragm at the aortic aperture and ascends the superior and posterior mediastinum between the descending thoracic aorta (to its left) and the azygos vein (to its right). The duct extends vertically in the chest and curves posteriorly to the left carotid artery and left internal jugular vein at the T5 vertebral level to empty into the junction of the left subclavian vein and left jugular vein, below the clavicle, near the shoulders.