The authors report on a chylothorax, a rare, although classical complication of left internal jugular vein cannulation. The anatomy of major lymphatic vessels including variations is illustrated. The mechanisms of central venous catheter associated chylothorax are discussed. Likewise described are pathophysiology, signs, clinical features, and differential diagnosis with special consideration of the triglyceride content as well as treatment options.

No abstract

Morphology o/ Ventriculo-Coronary Anastomoses i~ Heartswith Intact and Pathologically Altered Coronary Vessels Summary. With the aid of plastic casts and injected hearts, which were treated by the method of Drahn, a survey was given of the morphology of the ventriculo-coronary anastomoses. In principle we distinguish Thebesian vessels, ventriculo-capillary vessels, ventriculo-venous and ventriculo-arterial communications. The last two types can be summarized as ventriculo-vasal vessels. Besides the elaboration of the morphology the functional importance of ventriculo-coronary anastomoses in the presence of coronary ischemia was pointed out.

Gastrointestinal hemorrhage in a patient with a biliodigestive anastomosis necessitates exclusion of a bleeding source in the region of the choledocho- or hepaticojejunal anastomosis. This cannot be achieved by endoscopic methods. The source of bleeding can sometimes, though rarely, be localised by performance of selective angiography during hemorrhage. Laparotomy with exploration of the anastomosis during such an episode is at the same time a diagnostic and a therapeutic intervention. The surgical procedure of choice is de-anastomosis, resection of the bypassed jejunal loop and formation of a hepatico-duodenostomy.