A Case of Intestinal Lymphangiectasia complicating Peritonitis

Keiichi Hayashi, Chikashi Shibata, Yuji Funayama*, Kouhei Fukushima, Kou Miura, Kenichi Takahashi*, Hitoshi Ogawa, Tatsuya Ueno, Makoto Kinouchi and Iwao Sasaki

Division of Biological Regulation and Oncology and Department of Surgery, Tohoku University Postgraduate School of Medicine
Department of Surgery, Tohoku Rosai Hospital*

A 21-year-old man undergoing appendectomy for acute appendicitis in 2002 was found to have inflammation of the terminal ileum and mesentery. Further fluoroscopy of the small intestine showed a nodular lesion at the terminal ileum, but no other abnormalities were seen. He was followed up without definitive diagnosis as an outpatient and admitted for acute abdomen presenting lower abdominal pain and high fever in 2005. Nil per os and antibiotics administration relieved symptoms, but a mesentery tumor was not ruled out in imaging modalities necessitating surgery. Cystic lesions at the terminal ileum and mesentery necessitated partial ileal resection. Pathologically, lymph ducts were dilated, yielding a definitive diagnosis of intestinal lymphangiectasia.

Key words
lymphangiectasia, acute abdomen, peritonitis

Reprint requests
Keiichi Hayashi Division of Biological Regulation and Oncology and Department of Surgery, Tohoku University Postgraduate School of Medicine
1-1 Seiryou-machi, Aoba-ku, Sendai, 980-8574 JAPAN

Accepted
November 19, 2008

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