Title : The chyliferous vessels; From “De lactibus sive de lacteis venis” to the clinics of today
Abstract:
In 1622, while vivisecting a dog previously subjected to a poor diet, the famous Italian anatomist, Gaspare Aselli, accidentally noticed the presence of numerous vessels with milky contents in the intestine. He reported his experimental research in "De lactibus sive de lacteis venis" (On lacteals or lacteal veins), where chyliferous vessels were first described. Today we know that chyle is produced in the small intestine to absorb emulsified long-chain fatty acids, albumin, fibrin, chylomicrons (formed by triglycerides, cholesterol esters, proteins and phospholipids) and other components of the diet. It appears as an odourless milky fluid and is transported by the chyliferous vessels.
The chyliferous vessels are extremely important for the absorption of specific nutritional elements by directing them to the cisterna chyli without blocking the lymph node structures.
The pathophysiological procession of the chyliferous vessels is extremely varied and has a specific semiotic. The heterogeneity of the clinical excursus of patients with problems affecting this district is extremely wide and is closely linked to the variability of the etiopathogenesis. The symptoms change according to the anatomical structures involved, the location of the obstruction of the chyliferous vessels and the patient's compliance.
If the problem is located near the cisterna chyli, various backflow mechanisms can occur, including the following: pyelolymphatic backflow, ilioinguinal backflow, inguinoscrotal backflow, lower extremity backflow. Alternatively, if located above the cisterna chyli, thoracic backflow, intestinal backflow commonly occur if the base of the mesentery is altered.
In 1963, Marceau Servelle recorded structural alterations in the thoracic duct in great detail in patients with chylous reflux starting proximally and with subsequent distal progression towards pubic, renal and abdominal areas, including the genital and inguinal regions.
