Effect of thoracic duct to esophagus shunt in dogs with vena caval constriction

¹ Department of Surgery, New York University School of Medicine and Third and Fourth Surgical Divisions, Bellevue Hospital, New York City

Ascites developed promptly in four dogs in which the supradiaphragmatic vena cava was constricted. In another six dogs undergoing the same operation, the thoracic duct was drained by cannula into the esophageal lumen; ascites did not occur. Ascitic fluid forms following constriction of the inferior vena cava by leakage of excess liver lymph into the peritoneal cavity. Capacity of the thoracic duct to transport an increased quantity of lymph is limited by resistance to flow at the veno-lymphatic junction in the neck. This study demonstrates that ascites does not occur when resistance to excess thoracic duct lymph flow is removed by permitting free flow of lymph into the esophagus.