Small bowel lymphatic malformation: Clinical presentation and a comprehensive literature review.

Abstract

Small bowel lymphatic malformations are rare benign tumors of the lymphatic system, accounting for < 1% of intra-abdominal lymphatic malformations. They pose diagnostic challenges due to nonspecific presentations and are often misdiagnosed. To analyze clinical features, management, and outcomes of small bowel lymphatic malformations in adults through a case report and scoping review. A 47-year-old female with chronic abdominal pain underwent laparoscopic resection of an ileal lymphatic malformation. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews-guided scoping review of 97 adult cases (1991-2024) was conducted, extracting demographics, diagnostics, management, and outcomes. The cohort included 41 case reports and 2 case series (46% female, mean age 45.6 years), most commonly presenting with abdominal pain (74%), gastrointestinal bleeding (39%), or asymptomatic masses (9%). Lesions were predominantly in the jejunal mesentery (52%), with a mean size of 9.2 cm. Computed tomography identified lesions in 87% of cases, showing multiloculated cystic masses (78%). Surgical resection was the primary treatment (91%), with segmental bowel resection most frequent (65%). Complications occurred in 24% (infections: 13%), and recurrence in 11% (linked to incomplete resection). Complete excision achieved symptom resolution in 93%. Small bowel lymphatic malformations are rare but may cause significant morbidity. Surgical resection is curative, with laparoscopy emerging as a viable approach. Preoperative diagnosis remains challenging; heightened imaging awareness and complete excision are critical to prevent recurrence.