Disorders of the intestinal mesenteric lymphatic system

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.