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A. Mallick, A.R. Bodenham  British Journal of Anaesthesia 

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1 Disorders of the lymph circulation: their relevance to anaesthesia and intensive care 
A. Mallick, A.R. Bodenham  British Journal of Anaesthesia  Volume 91, Issue 2, Pages (August 2003) DOI: /bja/aeg155 Copyright © 2003 British Journal of Anaesthesia Terms and Conditions

2 Fig 1 Chyle in a bottle from a pleural drain, in the patient whose chest x-ray is shown in Figure 4. This fluid was photographed 5 days after injury, when the patient was receiving nasogastric feed. The fluid shows three distinct layers on standing. British Journal of Anaesthesia  , DOI: ( /bja/aeg155) Copyright © 2003 British Journal of Anaesthesia Terms and Conditions

3 Fig 2 An adult male with congenital bilateral lower limb lymphoedema, referred because he required bilateral knee replacement. The left side only has been treated by compression bandage therapy (see bandage marks on left lower leg), with impressive reduction in the lymphoedema. Photograph, with patient permission, courtesy of lymphoedema service, Cookridge Hospital, Leeds. British Journal of Anaesthesia  , DOI: ( /bja/aeg155) Copyright © 2003 British Journal of Anaesthesia Terms and Conditions

4 Fig 3 Late trophic changes in a leg following longstanding lymphoedema. So called ‘Elephantiasis’. Photograph, with patient permission, courtesy of lymphoedema service, Cookridge Hospital, Leeds. British Journal of Anaesthesia  , DOI: ( /bja/aeg155) Copyright © 2003 British Journal of Anaesthesia Terms and Conditions

5 Fig 4 Chest x-ray from an adult male with blunt chest trauma following severe deceleration injury in a road traffic accident. Multiple ribs fractures are seen on the left side (arrows). There are signs of left lung contusion and a left sided chest drain has been inserted to remove pleural fluid. A left thoracotomy and thoracic duct ligation was carried out after 10 days, when chyle loss was persistently greater than 3 litre day−1. This procedure cured his chyle leak. British Journal of Anaesthesia  , DOI: ( /bja/aeg155) Copyright © 2003 British Journal of Anaesthesia Terms and Conditions


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