Intestinal lymphangiectasia secondary to chronic midgut volvulus: A rare childhood presentation case report

Jasmin Martin , Narayanan Venkatasubramani , Nancy McGreal
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Abstract

Intestinal lymphangiectasia (IL) is a rare and unusual condition characterized by the abnormal dilation of lymphatic vessels within the intestines. IL can arise from an intrinsic defect in lymphatic development or as a secondary consequence of factors that obstruct the lymphatic system. In this case study, a 2-year-old child presenting with chronic diarrhea, vomiting, and inadequate weight gain was ultimately diagnosed with IL secondary to chronic volvulus, confirmed by CT abdomen/pelvis and MRI abdomen, with persistent manifestations of protein losing enteropathy requiring two exploratory laparotomies. The condition in this patient was attributed to lymphatic obstruction resulting from recurrent episodes of midgut volvulus, which led to impaired lymphatic drainage and subsequent development of IL. The main takeaway from this case reports is the importance of IL to the differential diagnosis because early abdominal imaging and surgical interventions are lifesaving.
继发于慢性中肠下垂的肠淋巴管扩张症:罕见的儿童病例报告
肠道淋巴管扩张症(IL)是一种罕见的异常病症,其特征是肠道内淋巴管异常扩张。肠淋巴管扩张症可能源于淋巴管发育的内在缺陷,也可能是淋巴系统受阻的继发性后果。在本病例研究中,一名 2 岁儿童因长期腹泻、呕吐和体重增加不足而最终被诊断为继发于慢性肠道裂孔的 IL,腹部 CT/骨盆和核磁共振腹部成像证实了这一诊断,该患儿持续表现为蛋白丢失性肠病,需要进行两次探查性开腹手术。该患者的病因是反复发作的中肠肠套叠导致淋巴管阻塞,淋巴管引流受阻,继而发展为IL。本病例报告的主要启示是IL在鉴别诊断中的重要性,因为早期腹部成像和手术干预可以挽救患者的生命。
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