The right lymphatic duct is a short vessel approximately 1 cm long draining lymph from the right side of the head, neck, and thorax, the right upper limb, and the right lung and pleura into the venous system at the junction of the right internal jugular and subclavian veins. It is formed by the union of the right jugular, right subclavian, and right bronchomediastinal trunks.
The right lymphatic duct is occasionally injured during right neck dissection, right subclavian artery surgery, or right internal jugular vein central line insertion, producing right-sided chylothorax or lymphatic fistula. Chylothorax from right duct injury is less common than left-sided (thoracic duct) chylothorax. The right duct is absent in approximately 20% of individuals where the three tributaries drain separately into the venous system. Recognition of potential right lymphatic injury guides intraoperative haemostasis in right posterior cervical triangle dissection.
Dissection in the right posterior cervical triangle or right supraclavicular fossa may encounter the right lymphatic duct or its tributaries, producing a lymphatic fistula or right-sided chylothorax; surgical clipping of visible lymphatic channels and pressure packing prevents post-operative chyle leak.
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