Primary Intestinal Lymphangiectasia Causing Intussusception and Small Bowel Obstruction

Abstract

Abdominal lymphangiectasia is a rare disease manifestation with a variety of anatomic locations and clinical presentations. The gastrointestinal tract may be affected, and lymphangiectasia originating in the wall of the intestine has rarely been described. We present a case of primary small bowel lymphangiectasia causing intussusception in a 30-year-old woman who presented with emesis and gastrointestinal bleeding. This case emphasizes the clinical presentation, diagnosis, and management in adults with abdominal lymphangiectasia. We highlight the importance of a high clinical suspicion for lymphangiectasia in an adult with acute abdomen to avoid catastrophic morbidity.

Figure 1.

Abdominal contrast-enhanced computed tomography showing a left-sided small bowel intussusception and moderate gastric distention.

Figure 2.

Capsule endoscopy revealing a protruding lesion in the jejunum, approximately 10 cm distal to the ligament of Treitz.

Figure 3.

Microscopic analysis of the resected lesion revealing a region of dilated lymphatic channels limited to the intestinal submucosa. There was no mucosal involvement or invasion.