Intestinal Lymphangiectasia Causing Massive Gastrointestinal Bleed

Lom, Jennifer; Dhere, Tanvi; Obideen, Kamil

doi:10.1097/mcg.0b013e3181a403af

Cited by 9 publications

(6 citation statements)

References 9 publications

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“…Primary intestinal lymphangiectasia (PIL) is a rare cause of obscure gastrointestinal (GI) bleeding that may range from chronic blood loss to massive bleeding. Few reports have been described in adults [1][2][3][4] and very few in children [5]. Here, we describe a case of an infant diagnosed with PIL who presented with severe iron deficiency anemia and hypoalbuminemia, in order to demonstrate the importance of considering abnormalities of the lymphatic system as a cause of anemia.…”

Section: Case Presentationmentioning

confidence: 89%

“…

Volume 2 -Issue -5

Case PresentationPrimary intestinal lymphangiectasia (PIL) is a rare cause of obscure gastrointestinal (GI) bleeding that may range from chronic blood loss to massive bleeding. Few reports have been described in adults [1][2][3][4] and very few in children [5]. Here, we describe a case of an infant diagnosed with PIL who presented with severe iron deficiency anemia and hypoalbuminemia, in order to demonstrate the importance of considering abnormalities of the lymphatic system as a cause of anemia.A 1 year-old child presented to Buzzi children hospital in October 2017 with 2 months of diffuse edema, pallor and weakness; his growth in weight was stable on the 10 th -25 th centile; otherwise his medical history was unremarkable.

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Severe Anemia in Children: A Clue of Primary Intestinal Lymphangectasia

Mantegazza¹,

Galli²,

Dilillo³

et al. 2019

GMR

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Volume 2 -Issue -5 Case PresentationPrimary intestinal lymphangiectasia (PIL) is a rare cause of obscure gastrointestinal (GI) bleeding that may range from chronic blood loss to massive bleeding. Few reports have been described in adults [1][2][3][4] and very few in children [5]. Here, we describe a case of an infant diagnosed with PIL who presented with severe iron deficiency anemia and hypoalbuminemia, in order to demonstrate the importance of considering abnormalities of the lymphatic system as a cause of anemia.A 1 year-old child presented to Buzzi children hospital in October 2017 with 2 months of diffuse edema, pallor and weakness; his growth in weight was stable on the 10 th -25 th centile; otherwise his medical history was unremarkable. Physical examination revealed significant pallor and swelling with anasarca. In particular he presented with periorbital, hands, scrotal, sacral, feet and limb-pitting edema. Moreover, cardiac examination revealed high heart rate and an unknown systolic 2/6 murmur. Upon primary evaluation, laboratory tests showed severe irondeficiency anemia (hemoglobin 3,8g/dl, mean corpuscular volume 57,3fl, ferritin 1µg/l, reticulocytes 0,9%), hypoalbuminemia (2g/ dl) and hypogammaglobulinemia (0,1g/dl). No proteinuria was found in his urinalysis. Abdominal ultrasound revealed ascites; no alterations were found on chest X-ray or echocardiography. Fecal occult blood was highly positive.In the hypothesis of an enteropathy we first considered celiac disease as a diagnosis, however specific celiac type serology was negative and upper gastrointestinal endoscopy and histology were unremarkable. On ileo-colonoscopy no alteration was found. A 99mT-DTPA scintigraphy showed an abnormal diffusion of the radioisotope in the intestinal lumen in particular in the small bowel and suggested a diagnosis of a protein losing enteropathy Therefore,

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Section: Case Presentationmentioning

confidence: 89%

“…

Volume 2 -Issue -5

…”

mentioning

confidence: 89%

Severe Anemia in Children: A Clue of Primary Intestinal Lymphangectasia

Mantegazza¹,

Galli²,

Dilillo³

et al. 2019

GMR

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“…[3] Bleeding from IL is uncommon and ranges from chronic blood loss to massive bleeding. [4][5][6] Acute gastrointestinal bleeding from a unifocal type of IL is rare. [4,6] Obstruction of the normal efferent flow of the lymph and subsequent opening of latent lymphatic-venous or abnormal lymphatic-arterial connections explains the hemorrhage in IL.…”

Section: Discussionmentioning

confidence: 99%

Focal intestinal lymphangiectasia: An unusual cause of acute overt obscure gastrointestinal bleeding

Jha

Thandassery

Goenka

2014

Journal of Digestive Endoscopy

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Detection of bleeding lesion in a patient of acute overt obscure gastrointestinal bleeding is a real challenge. Recently, authors have showed superiority of urgent capsule endoscopy (CE) over angiography in patients with acute overt obscure gastrointestinal bleeding. Focal type of intestinal lymphangiectasia is a rare cause of acute gastrointestinal bleeding. Here, we describe a case of focal lymphangiectasia who presented to us with acute overt obscure gastrointestinal bleeding and diagnosed by urgent CE.

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“…Furthermore malabsorption of calcium, phosphate and vitamin D results in a high risk of osteoporosis and osteomalacia with decreases in bone mineral density and abnormal mineralisation of the protein matrix 5 . Some cases of gastrointestinal bleeding were associated with IL 8 , in one report massive bleeding caused by IL localised to the jejunum needed a surgical resection 9 . Another study showed evidence of a strong association between small bowel angiodysplasia and lymphangiectasia, so this could be another explanation for intestinal bleeding and anaemia found in IL patients 10 .…”

Section: Discussionmentioning

confidence: 99%

Chronic diarrhea and abdominal mass: A case of intestinal lymphangiectasia

Trovato¹,

Musumeci²,

Bonanno³

et al. 2013

OA Case Reports

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IntroductionIntestinal lymphangiectasia is a protein-losing enteropathy caused by congenital malformation or secondary obstruction of intestinal lymphatic vessels, which usually causes excessive protein loss in the intestine and malabsorption syndrome. Patients may be asymptomatic or complain of oedema, diarrhoea, hypoalbuminaemia and other deficiencies. This article reports a case of chronic diarrhoea and an abdominal mass. Case reportWe present the case of a 70-year-old woman who came to our gastroenterological clinic for diarrhoea. Blood and stool tests were within the normal ranges, except for a mild eosinophilia and a high C-reactive protein. The ultrasound scan showed a cystic retropancreatic mass, and the following computed tomography scan confirmed the presence of the mass without sure continuity with the dorsal pancreas. The fine needle aspiration performed during an echoendoscopy, permitted the complete aspi ration of the fluid and the cytological analysis that showed numerous lymphocytes. The diagnosis of Intestinal lymphangiectasia was done, and

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Intestinal Lymphangiectasia Causing Massive Gastrointestinal Bleed

Cited by 9 publications

References 9 publications

Severe Anemia in Children: A Clue of Primary Intestinal Lymphangectasia

Severe Anemia in Children: A Clue of Primary Intestinal Lymphangectasia

Focal intestinal lymphangiectasia: An unusual cause of acute overt obscure gastrointestinal bleeding

Chronic diarrhea and abdominal mass: A case of intestinal lymphangiectasia

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