The intestinal lymphatic trunk carries lymph from the stomach, intestines, liver, pancreas and spleen. It forms from efferent vessels of the coeliac and superior mesenteric (preaortic) lymph nodes and is often multiple. It joins the lumbar trunks to form the cisterna chyli, the lower end of the thoracic duct.
| Origin | Efferent vessels of the coeliac and superior mesenteric lymph nodes |
|---|---|
| Course | Descends or passes backward from the preaortic nodes to join the lumbar trunks at the cisterna chyli in front of the L1-L2 vertebrae |
| Branches |
|
After a fatty meal, the intestinal trunk carries chyle, milky lymph rich in fat absorbed by the intestinal lacteals. Injury to it during retroperitoneal or pancreatic surgery, or obstruction by lymphoma or other tumours, can cause chylous ascites. Blocked intestinal lymph flow also underlies intestinal lymphangiectasia, a cause of protein-losing enteropathy with swelling and low albumin.
Leakage of chyle from the intestinal trunk or cisterna chyli after surgery, trauma or tumour fills the abdomen with milky fluid high in triglycerides, managed with a low-fat or medium-chain triglyceride diet, drainage and sometimes surgery.
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