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Fistulizing nodular lymphoid hyperplasia.

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    Fistulizing nodular lymphoid hyperplasia (NLH) of the GI tract is rare in adults. This case highlights surgical management for complicated NLH, mirroring fistulizing ileitis treatment.

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    Area of Science:

    • Gastroenterology
    • Surgical Pathology

    Background:

    • Nodular lymphoid hyperplasia (NLH) is a rare gastrointestinal condition in adults, typically asymptomatic with few documented complications.
    • This report focuses on an unusual presentation of focal lymphoid hyperplasia in the GI tract.

    Observation:

    • A 23-year-old female presented with a fistulizing disease of the terminal ileum and cecum, complicated by a lower abdominal abscess.
    • Initial treatment with CT-guided drainage and antibiotics failed to resolve the abscess.

    Findings:

    • Surgical intervention, specifically ileocecal resection, was performed.
    • Pathological examination confirmed focal lymphoid hyperplasia as the underlying diagnosis.

    Implications:

    • This case represents the first reported instance of fistulizing NLH, a rare complication in adults.
    • Management strategies for fistulizing NLH should align with those for fistulizing ileitis.
    • Surgery is reserved for complicated cases unresponsive to conservative medical management.