Asymptomatic intestinal lymphangiectasia: Case report [CONSIDERAZIONI SU UN CASO DI LINFANGECTASIA INTESTINALE ASINTOMATICA]

Abstract Primitive lymphangiectasia of the intestine, is a usually symptomatic enteropathy. Asymptomatic forms have been observed, however, characterized by an incidental endoscopic appearance. Asymptomatic lymphangiectasia of the duodenum is believed to be functional and transitory, probably linked to absorption of alimentary fat. Since such condition is extremely rare, no precise classification and pathophysiological explanation are so far available. We observed a case of duodenal lymphangiectasia associated to a lymphangioma of the 4th finger of the left hand. The patient was asymptomatic and no relevant abnormalities of fat metabolism and nutritional status could be detected although the association with a congenital lymphovascular abnormality might suggest the presence of a primitive disease. Interestingly after one year follow-up, endoscopy and histology detected again a picture of duodenal lymphangiectasia. The features of the case that we report here, may suggest that permanent endoscopical/histological aspect may persist also in 'functional', asymptomatic form. Lymphangiectasia may then represent in such cases, a compensatory mechanism following a fatty diet, in order to slow intestinal fat absorption. The association with lymphovascular malformation should be coincidential.