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CC BY 4.0 · Journal of Gastrointestinal and Abdominal Radiology
DOI: 10.1055/s-0045-1809654
Case-in-Discussion

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

Gayathri S. Menon 
1   Department of Radiology, Apollo Hospitals, Bangalore, Karnataka, India
,
Shrivalli Nandikur
1   Department of Radiology, Apollo Hospitals, Bangalore, Karnataka, India
,
Prasanna S. Rao
2   Department of Medical Gastroenterology, Apollo Hospitals, Bangalore, Karnataka, India
,
Swarna Shivakumar
3   Department of Pathology, Apollo Hospitals, Bangalore, Karnataka, India
,
Aruna R. Patil
1   Department of Radiology, Apollo Hospitals, Bangalore, Karnataka, India
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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 endoscopy


Publication History

Article published online:
17 June 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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