Abstrakt
Primary intestinal lymphangiectasia is a rare cause of exudative enteropathy. Symptoms include diarrhoea, peripheral oedema, lymph oedema of the limbs, malaise and weight loss.
A 25-year-old female was admitted to our hospital because of gastrointestinal bleeding, which had occurred after blunt trauma of the abdomen. The endoscopic procedures (gastroscopy, push enteroscopy, wireless capsule) showed oedematous mucosa with scattered white spots, white villi, chyle-like matter covering the mucosa and diffuse bleeding of the small intestine.
The other procedures (lymphoscintigraphy, lymphography) showed a picture of hyperplasia and dysplasia of the lymphatic vessels. In accordance with these investigations the final diagnosis of primary intestinal lymphangiectasia was established.
The patient was treated with an MCT enriched diet, lanreotide and, finally, by tranexamic acid. During therapy, there was a decrease in loss of blood and proteins.
However, other complications occurred during the treatment (chylothorax, respiratory failure, recurrent sepsis, thrombosis of vena cava superior). The patient is still hospitalized in the intensive care unit, and her prognosis remains uncertain.