From Overlooked to Unveiled: A Rare Case of Focal Jejunal Lymphangiectasia Presenting as Obscure Gastrointestinal Bleeding

Intestinal lymphangiectasia (IL) is a rare disorder characterized by dilated lymphatic vessels within the small bowel wall. Focal IL is exceptionally uncommon, with gastrointestinal (GI) bleeding being a rare presentation. We report a case of a 50-year-old man presenting with recurrent melena and ch...

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Bibliographic Details
Main Authors: Gayathri S. Menon, Shrivalli Nandikur, Prasanna S. Rao, Swarna Shivakumar, Aruna R. Patil
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd.
Series:Journal of Gastrointestinal and Abdominal Radiology
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1809654
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Summary:Intestinal lymphangiectasia (IL) is a rare disorder characterized by dilated lymphatic vessels within the small bowel wall. Focal IL is exceptionally uncommon, with gastrointestinal (GI) bleeding being a rare presentation. We report a case of a 50-year-old man presenting with recurrent melena and chronic iron deficiency anemia, in whom multiple endoscopic and radiological evaluations were initially inconclusive. Capsule endoscopy identified white punctate and plaque-like mucosal changes in the mid-jejunum, prompting a retrospective review of prior computed tomographic images, which uncovered a previously overlooked focal eccentric septate hypodense jejunal lesion. Surgical resection confirmed focal IL histologically. This case highlights the importance of a multidisciplinary approach and a high index of clinical suspicion in the evaluation of obscure GI bleeding, as focal IL is rare and may present with subtle imaging findings that are easily missed.
ISSN:2581-9178