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DOI: 10.1055/s-0045-1809654
From Overlooked to Unveiled: A Rare Case of Focal Jejunal Lymphangiectasia Presenting as Obscure Gastrointestinal Bleeding
Abstract
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.
Keywords
intestinal lymphangiectasia - focal jejunal lymphangiectasia - obscure gastrointestinal bleeding - CT imaging - capsule endoscopyPublikationsverlauf
Artikel online veröffentlicht:
17. Juni 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Yang DM, Jung DH. Localized intestinal lymphangiectasia: CT findings. AJR Am J Roentgenol 2003; 180 (01) 213-214
- 2 Suresh N, Ganesh R, Sankar J, Sathiyasekaran M. Primary intestinal lymphangiectasia. Indian Pediatr 2009; 46 (10) 903-906
- 3 Jha AK, Thandassery RB, Goenka MK. Focal intestinal lymphangiectasia: an unusual cause of acute overt obscure gastrointestinal bleeding. J Dig Endosc 2014; 5: 16-23
- 4 Poirier VC, Alfidi RJ. Intestinal lymphangiectasia associated with fatal gastrointestinal bleeding. Am J Dig Dis 1973; 18 (01) 54-58
- 5 Ingle SB, Hinge Ingle CR. Primary intestinal lymphangiectasia: minireview. World J Clin Cases 2014; 2 (10) 528-533
- 6 Stevens RL, Jones B, Fishman EK. The CT halo sign: a new finding in intestinal lymphangiectasia. J Comput Assist Tomogr 1997; 21 (06) 1005-1007
- 7 Tanabe S. Diagnosis of obscure gastrointestinal bleeding. Clin Endosc 2016; 49 (06) 539-541
- 8 Lecleire S, Iwanicki-Caron I, Di-Fiore A. et al. Yield and impact of emergency capsule enteroscopy in severe obscure-overt gastrointestinal bleeding. Endoscopy 2012; 44 (04) 337-342
- 9 Freeman HJ, Nimmo M. Intestinal lymphangiectasia in adults. World J Gastrointest Oncol 2011; 3 (02) 19-23