MRI in Primary Intestinal Lymphangiectasia: A Diagnostic Tool and to Delineate Localization of Involvement
ثبت نشده
چکیده
Intestinal lymphangiectasia (IL) is a rare protein losing enteropathy caused by congenital malformation or obstruction of the intestinal lymphatic drainage system [1]. Elevated pressure in the intestinal lymphatic system causes dilatation and rupture of the lacteals, with loss of lymphatic fluid which is rich in fat and protein. Consequently the clinical features of diarrhea, growth retardation, edema, ascites and hypo-proteinemia develop [1,2]. Depending on the presence of an underlying etiology IL could be classified as primary or secondary. Primary IL (PIL) also known as Waldman disease is rather rare entity with not more than 200 cases reported so far [2,3]. Given the rarity of PIL the evaluation and management strategies have not changed much over the past decade [2]. There have been reports on successful usage of computerized tomography (CT) scan and video capsule endoscopy (VCE) to diagnose and delineate the extent of intestinal involvement [4-12]. The significance of determining the extent of involvement lies in the good response to surgical excision of the involved intestinal segment if a localized disease is present, as medical management outcomes are modest and often frustrating [13-15]. Localized involvement poses a problem of diagnosis as well, if the region of involvement is further to the duodenum and not under direct visualization in the screening upper GI endoscopy. The utilization of VCE and CT scan for diagnosis and localization of disease in children is associated with issues related to size of capsule endoscope and the radiation exposure in CT scanning. Hence we tried to analyze the usage of MRI and as a diagnostic tool and also for localization of the disease in children with PIL.
منابع مشابه
Accidental discovery of a hydatid cyst with primary presentation in an unusual location: a case report
A hydatid cyst is a zoonotic infection caused by the larval forms of mostly the Echinococcus granulosus. In humans, the most common site of cyst development is the liver (60%), followed by the lungs (20%), and much less commonly in other organs such as kidney, spleen, brain, and other soft tissues. The localization of cysts in muscles and subcutaneous is very rare. We report a case of 38-year-o...
متن کاملPrimary intestinal lymphangiectasia diagnosed by double-balloon enteroscopy and treated by medium-chain triglycerides: a case report
UNLABELLED INTRODUCTION Primary intestinal lymphangiectasia is a disorder characterized by exudative enteropathy resulting from morphologic abnormalities of the intestinal lymphatics. Intestinal lymphangiectasia can be primary or secondary, so the diagnosis of primary intestinal lymphangiectasia must first exclude the possibility of secondary intestinal lymphangiectasia. A double-balloon ent...
متن کاملSurgical therapy of primary intestinal lymphangiectasia in adults
Primary intestinal lymphangiectasia (PIL) is a rare disorder, especially in adults. It causes a local disruption of chylus transport and is part of the exudative gastroenteropathies. Conservative therapy includes dietary measures or somatostatin medication. Taking the differential diagnosis of PIL into consideration is a major challenge, since patients suffering from PIL may present with diarrh...
متن کاملPrimary intestinal lymphangiectasia in an elderly female patient
Protein loss via the gut can be caused by a number of gastrointestinal disorders, among which intestinal lymphangiectasia has been described to not only lead to a loss of proteins but also to a loss of lymphocytes, resembling secondary immunodeficiency. We are reporting on a 75-year-old female patient who came to our hospital because of a minor stroke. She had no history of serious infections. ...
متن کاملI-59: Diagnostic Accuracy of Physical Examination,Transvaginal Sonography, RectalEndoscopic Sonography, and Magnetic ResonanceImaging to Diagnose Deep InfiltratingEndometriosis
Background: To compare the value of physical examination, transvaginal sonography (TVS), rectal endoscopic sonography (RES), and magnetic resonance imaging (MRI) for the assessment of different locations of deep infiltrating endometriosis (DIE). Materials and Methods: Ninety-two consecutive patients with clinical evidence of pelvic endometriosis. Physical examination, TVS, RES, and MRI, perform...
متن کامل