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Disorders of the intestinal mesenteric lymphatic system

U Fox1, G Lucani

  • 1General Surgery Department, Ospedale Santa Corona, Milan, Italy.

Lymphology
|June 1, 1993
PubMed
Summary

Disorders of intestinal lymphatic transport, like intestinal lymphangiectasia, cause protein losing enteropathy (PLE). Management includes dietary changes or surgery, with satisfactory outcomes reported in a study of 12 patients.

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Area of Science:

  • Gastroenterology
  • Vascular Medicine
  • Surgical Pathology

Background:

  • Intestinal lymphatic transport disorders are rare, often presenting as protein losing enteropathy (PLE).
  • Associated symptoms include hypoproteinemia, lymphedema, chyluria, chylometrorrhea, and chylous ascites.
  • Intestinal lymphangiectasia is a primary cause of these lymphatic disorders.

Purpose of the Study:

  • To examine the diverse clinical presentations and pathophysiology of lymphangiectasia syndromes.
  • To evaluate treatment outcomes for patients with protein losing enteropathy secondary to primary intestinal lymphangiectasia.

Main Methods:

  • Review of clinical signs, symptoms, and laboratory findings.
  • Diagnostic confirmation via contrast small bowel series, lymphography, and laparoscopy.
  • Analysis of treatment strategies (dietary and surgical) in 12 patients from 1980-1991.

Main Results:

  • Twelve patients with protein losing enteropathy due to primary intestinal lymphangiectasia were identified.
  • Eight patients received non-operative dietary management.
  • Four patients underwent surgical interventions including segmental jejunal resection, lymphatic-mesenteric venous anastomosis, or peritoneal-venous shunt placement.

Conclusions:

  • Intestinal lymphangiectasia presents with varied clinical manifestations and requires accurate diagnosis.
  • Both dietary and surgical treatments can yield satisfactory results for protein losing enteropathy.
  • Further research into lymphatic transport disorders is warranted.

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