ABSTRACT
Other pleural effusions, including empyema and hemothorax will also be briefly discussed. Since malignant effusions rarely occur in neonates, they have been omitted from the discussion.
Lymph is collected in the cisterna chyli and reaches the venous system via the thoracic duct, which ascends in the posterior mediastinum between the azygos vein and the descending aorta. This duct crosses to the left at the
level of the fifth thoracic vertebra, continues its ascent into the neck on the left of the esophagus, and opens into the venous system at the confluence of the internal jugular and subclavian veins. In the thorax it receives lymph from the parietal pleura of both sides via several collecting trunks. Lymphatic branches from structures in the posterior mediastinum and from the left lung and its pleura join to form the left bronchomediastinal trunk; this trunk opens into the thoracic duct or directly into the great veins. There are also several potential lymphovenous communications that may function when the main duct is traumatized or blocked (Fig. 29.1).
