Skip to main content
Log in

A detailed pathway and termination of thoracic duct in a Japanese female cadaver with situs inversus totalis

  • Case Report
  • Published:
Anatomical Science International Aims and scope Submit manuscript

Abstract

Although the thoracic duct (TD) requires special attention during thoracic surgery, to our knowledge, its detailed course in the situs inversus totalis (SIT) case has not been reported. We encountered an 86-year-old Japanese female cadaver with SIT during a student anatomical practice and examine the TD. The TD originated from the cisterna chyli at the level of the 2nd lumbar vertebra, ascended along with the left side of aorta and then passed behind the aortic arch on the right side of the esophagus. The TD turned right at the first thoracic vertebra and finally emptied into the basal portion of the right external jugular vein without branching. The present running pathway of the TD was approximately in the inverted position of the normal, but its connection site to the vein and manner was very rare and has not been reported to date. Therefore, this junctional anomaly may occur during the developmental period in SIT. Further anatomical and embryological studies are required, but this report provides useful morphogenetic information of the TD and lymphovenous junction in SIT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Adachi B (1953) Der Ductus thoracicus der Japaner. In: Kihara T (ed) Das Lymphgefäßsystem der Japaner. Kenkyusha, Kyoto, pp 7–83 (in German)

    Google Scholar 

  • Akcali O, Kiray A, Ergur I, Tetik S, Alici E (2006) Thoracic duct variations may complicate the anterior spine procedures. Eur Spine J 15:1347–1351

    Article  Google Scholar 

  • Cao Y, Li J, Shen L et al (2017) Gastric cancer in a situs inversus totalis patient with multiple intestinal and vessel variations related to gastrectomy surgery: a case report and literature review. Medicine 96:e8209

    Article  Google Scholar 

  • Chen H, Shoumura S, Emura S (2006) Bilateral thoracic ducts with coexistent persistent left superior vena cava. Clin Anat 19:350–353

    Article  Google Scholar 

  • Chiba T, Narita H, Shimoda H (2017) Fine structure of human thoracic duct as revealed by light and scanning electron microscopy. Biomed Res 38:197–205

    Article  CAS  Google Scholar 

  • Douard R, Feldman A, Bargy F, Loric S, Delmas V (2000) Anomalies of lateralization in man: a case of total situs inversus. Surg Radiol Anat 22:293–297

    Article  CAS  Google Scholar 

  • Hägerling R, Pollmann C, Andreas M et al (2013) A novel multistep mechanism for initial lymphangiogenesis in mouse embryos based on ultramicroscopy. EMBO J 32:629–644

    Article  Google Scholar 

  • Johnson OW, Chick JF, Chauhan NR et al (2016) The thoracic duct: clinical importance, anatomic variation, imaging, and embolization. Eur Radiol 26:2482–2493

    Article  Google Scholar 

  • Kojima F, Koishi S (1937) Ein fall von situs inversus totalis. J Kyoto Pref Univ Med 20:908–914 (in Japanese with German summary)

    Google Scholar 

  • Kyuno D, Kimura Y, Imamura M et al (2013) Pancreaticoduodenectomy for biliary tract carcinoma with situs inversus totalis: difficulties and technical notes based on two cases. World J Surg Oncol 17:312

    Article  Google Scholar 

  • Mano Y, Adachi N, Murakami G, Yokoyama T, Dodo Y (2006) Human situs inversus of the thoracoabdominal structures. Anat Sci Int 81:7–20

    Article  Google Scholar 

  • Marchiò S, Astanina E, Bussolino F (2013) Emerging lymphae for the fountain of life. EMBO J 32:609–611

    Article  Google Scholar 

  • Okuda I, Udagawa H, Hirata K, Nakajima Y (2011) Depiction of the thoracic duct by magnetic resonance imaging: comparison between magnetic resonance imaging and the anatomical literature. Jpn J Radiol 29:39–45

    Article  Google Scholar 

  • Phang K, Bowman M, Phillips A, Windsor J (2014) Review of thoracic duct anatomical variations and clinical implications. Clin Anat 27:637–644

    Article  CAS  Google Scholar 

  • Pillay TG, Singh B (2016) A review of traumatic chylothorax. Injury 47:545–550

    Article  CAS  Google Scholar 

  • Shimada K, Sato I (1997) Morphological and histological analysis of the thoracic duct at the jugulo-subclavian junction in Japanese cadavers. Clin Anat 10:163–172

    Article  CAS  Google Scholar 

  • Taniya S, Ohmachi N, Akita M, Ohsaki R, Kaneko K (1983) A case of situs inversus viscerum totalis associated with various abnormalities. Kaibogaku Zasshi 59:94–103 (in Japanese with English summary)

    Google Scholar 

  • Tohno Y, Tohno S, Matsumoto H et al (1983) A case of situs inversus viscerum totalis observed in a 95-year-old female. Kaibogaku Zasshi 58:606–613 (in Japanese with English summary)

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

HN, SW, KU and HS conducted the dissections. HN, SW and HS designed the anatomical investigations. KU provided surgical considerations. HN and HS wrote the manuscript. All authors approved the paper.

Corresponding author

Correspondence to Hiroshi Shimoda.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Narita, H., Watanabe, S., Umemura, K. et al. A detailed pathway and termination of thoracic duct in a Japanese female cadaver with situs inversus totalis. Anat Sci Int 95, 425–428 (2020). https://doi.org/10.1007/s12565-020-00532-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12565-020-00532-4

Keywords

Navigation