[Surgical therapy of segmental jejunal, primary intestinal lymphangiectasia].
Identifieur interne : 005417 ( Ncbi/Curation ); précédent : 005416; suivant : 005418[Surgical therapy of segmental jejunal, primary intestinal lymphangiectasia].
Auteurs : W. Kneist ; D G Drescher ; T. Hansen ; K F Kreitner ; H. LangSource :
- Zeitschrift fur Gastroenterologie [ 1439-7803 ] ; 2013.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- pathology : Jejunal Diseases, Jejunum, Lymphangiectasis, Intestinal, Lymphedema.
- surgery : Jejunal Diseases, Jejunum, Lymphangiectasis, Intestinal, Lymphedema.
- Female, Humans, Middle Aged, Treatment Outcome.
Abstract
Primary intestinal lymphangiectasia (PIL) is a protein-losing, exsudative gastroenteropathy causing lymphatic obstruction. Diagnosis depends on clinical examination and histological findings. Conservative treatment modalities include a low-fat diet and enteral nutritional therapy in order to reduce enteric protein loss and to improve fat metabolism. Other treatment options consist of administration of antiplasmin or octreotide to lower lymph flow and secretion. We report on a 58-year-old patient who underwent exploratory laparotomy due to a worsening physical status, recurrent chylaskos and leg oedema under conservative dietary therapy. Intraoperative findings showed a typical PIL of the jejunum about 20 cm distal to the Treitz's ligament. Histological examinations confirmed this diagnosis. One year after segmental small bowel resection (105 cm) with end-to-end anastomosis the patient is healthy, free of symptoms, has gained weight and his serum protein level has increased. Intraabdominal ascites and leg oedema have not reoccurred since.
DOI: 10.1055/s-0031-1273473
PubMed: 23229460
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W. Kneist<affiliation><nlm:affiliation>Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsmedizin der Johannes-Gutenberg-Universität, Mainz.</nlm:affiliation>
<wicri:noCountry code="subField">Mainz</wicri:noCountry>
</affiliation>
Le document en format XML
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<term>Humans</term>
<term>Jejunal Diseases (pathology)</term>
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<term>Jejunum (pathology)</term>
<term>Jejunum (surgery)</term>
<term>Lymphangiectasis, Intestinal (pathology)</term>
<term>Lymphangiectasis, Intestinal (surgery)</term>
<term>Lymphedema (pathology)</term>
<term>Lymphedema (surgery)</term>
<term>Middle Aged</term>
<term>Treatment Outcome</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Femelle</term>
<term>Humains</term>
<term>Jéjunum ()</term>
<term>Jéjunum (anatomopathologie)</term>
<term>Lymphangiectasie intestinale ()</term>
<term>Lymphangiectasie intestinale (anatomopathologie)</term>
<term>Lymphoedème ()</term>
<term>Lymphoedème (anatomopathologie)</term>
<term>Maladies du jéjunum ()</term>
<term>Maladies du jéjunum (anatomopathologie)</term>
<term>Résultat thérapeutique</term>
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<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Jéjunum</term>
<term>Lymphangiectasie intestinale</term>
<term>Lymphoedème</term>
<term>Maladies du jéjunum</term>
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<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Jejunal Diseases</term>
<term>Jejunum</term>
<term>Lymphangiectasis, Intestinal</term>
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<term>Jejunum</term>
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<term>Middle Aged</term>
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<term>Lymphangiectasie intestinale</term>
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<front><div type="abstract" xml:lang="en">Primary intestinal lymphangiectasia (PIL) is a protein-losing, exsudative gastroenteropathy causing lymphatic obstruction. Diagnosis depends on clinical examination and histological findings. Conservative treatment modalities include a low-fat diet and enteral nutritional therapy in order to reduce enteric protein loss and to improve fat metabolism. Other treatment options consist of administration of antiplasmin or octreotide to lower lymph flow and secretion. We report on a 58-year-old patient who underwent exploratory laparotomy due to a worsening physical status, recurrent chylaskos and leg oedema under conservative dietary therapy. Intraoperative findings showed a typical PIL of the jejunum about 20 cm distal to the Treitz's ligament. Histological examinations confirmed this diagnosis. One year after segmental small bowel resection (105 cm) with end-to-end anastomosis the patient is healthy, free of symptoms, has gained weight and his serum protein level has increased. Intraabdominal ascites and leg oedema have not reoccurred since.</div>
</front>
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