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Updated: Jun 20, 2026
04:14
Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
[Protein-losing enteropathy caused by a thoracic cyst]
Atef Kinani1, Troels Havelund, Torben Knudsen
1Medicinsk Gastroenterologisk Afdeling, Medicinsk Område, Sydvestjysk Sygehus, Esbjerg, DK-6700 Esbjerg. atefhj@yahoo.dk
Ugeskrift for Laeger
|September 8, 2009
Summary
A 58-year-old man with peripheral edema and low serum proteins experienced significant gastrointestinal protein loss. Surgical removal of a thoracic cyst resolved the protein loss, indicating lymph drainage obstruction as the cause.
Area of Science:
- Gastroenterology
- Internal Medicine
- Surgical Pathology
Background:
- Gastrointestinal protein loss can manifest with peripheral edema and hypoalbuminemia.
- Thoracic lymphatic obstruction is a rare but potential cause of protein-losing enteropathy.
Observation:
- A 58-year-old male presented with peripheral edema and low serum protein levels.
- Diagnostic evaluation revealed significant gastrointestinal protein loss, quantified at 12.5% over 96 hours using 111Indium-labelled transferrin.
- Capsule endoscopy identified villous lymphangiectasia, suggesting impaired lymphatic drainage.
Findings:
- A large left-sided thoracic cyst was identified as the likely cause of obstructed thoracic lymph drainage.
- The gastrointestinal protein loss was determined to be secondary to this lymphatic obstruction.
- Surgical excision of the thoracic cyst led to complete resolution of the patient's symptoms and protein loss.
Implications:
- This case highlights the importance of considering lymphatic obstruction in the differential diagnosis of protein-losing enteropathy.
- Surgical intervention for thoracic cysts causing lymphatic compromise can effectively treat secondary gastrointestinal protein loss.
- Early diagnosis and management of thoracic lymphatic obstruction are crucial for preventing complications associated with protein-losing enteropathy.
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