A Case of Small Bowel Lymphangiectasia that Presented with Gastrointestinal Bleeding and was Treated by Small Bowel Resection

Korean J Med > Volume 80(2); 2011 > Article

Original Article

The Korean Journal of Medicine 2011;80(2):91-95.

A Case of Small Bowel Lymphangiectasia that Presented with Gastrointestinal Bleeding and was Treated by Small Bowel Resection

Jae Eun Lee1, Jung Ho Park1, Wan Park1, Mi Hye Seo1, Won Seok Choi1, Chang Suk Song1, Kyoung Bun Lee2

소장출혈로 나타나 소장절제술로 완치된 장림프관확장증 1예

이재은, 박정호, 박완, 서미혜, 최원석, 송창석, 이경분

Abstract

Intestinal lymphangiectasia (IL) is a rare disorder, characterized by dilatation of intestinal lymphatics and leakage from ruptured lacteals to the intestinal lumen. Primary IL may be due to a congenital malformation of the lymphatic system, whereas secondary IL is caused by decreased lymph flow from thoracic ductsdue to elevated left subclavian vein pressure as a result of a preceding inflammatory or neoplastic disease. IL can present as protein-losing enteropathy with clinical manifestations of hypoproteinemia, hypoalbuminemia, edema, ascites, or pleural effusions. In very rare cases, it can present as severe intestinal bleeding. We experienced a 48-year-old woman presenting with recurring hematochezia and melena. She was diagnosed bydouble balloon enteroscopy, and surgical resection was needed to stop bleeding. In conclusion, IL can present clinically as painless chronic blood loss. If IL is locally distributed, surgical resection may be needed to control bleeding and to exclude other underlying causes in some patients.

Key Words: Intestinal lymphangiectasia; Double balloon enteroscopy; Hematochezia