Primary intestinal lymphangiectasia presenting with intussusception in a child.

Abstract

Intestinal lymphangiectasia is a protein losing intestinal disease caused by congenital malformation or obstruction of intestinal lymphatics. Based on etiology, it is classified as primary or secondary. Primary Intestinal Lymphangiectasia (PIL) is a rare disorder of intestinal lymphatic dysfunction and may present with a wide spectrum of clinical manifestations but it very infrequently presents as intussusception in children. To the best of our knowledge this is the second only reported case in children, both cases being described from the Indian subcontinent. A 12-year-old male presented complaining of abdominal pain for one week. Examination revealed a palpable mass in the right upper quadrant and abdominal tenderness. A provisional diagnosis of acute intestinal obstruction was made and the child underwent an emergency laparotomy which revealed a segment of distal ileum displaying intussusception. On cut opening, no growth was seen. Histopathology of the telescoped segment showed many ectatic and dilated lymphatic channels filled with lymph. PIL should be considered in the differential diagnosis in children presenting with intestinal obstruction.