Rao S S, Dundas S, Holdsworth C D
Dig Dis Sci. 1987 Aug;32(8):939-42. doi: 10.1007/BF01296718.
We report a case of intestinal lymphangiectasia secondary to radiotherapy and chemotherapy. The patient also had small bowel bacterial overgrowth and pancreatic insufficiency. Lymphatic ectasia as a histological feature has been described previously in association with postradiotherapy malabsorption, but radiation-induced lymphangiectasia producing clinical manifestations has hitherto not been reported. Replacement of dietary long-chain fats with medium-chain triglycerides, pancreatic enzyme supplements, and a short course of oxytetracycline, resulted in dramatic clinical improvement. The possibility of intestinal lymphangiectasia should be borne in mind in patients with postradiotherapy malabsorption. A low serum albumin and lymphocyte count should draw attention to this possibility.
我们报告一例继发于放疗和化疗的肠淋巴管扩张症。该患者还存在小肠细菌过度生长和胰腺功能不全。淋巴管扩张作为一种组织学特征,此前已有报道与放疗后吸收不良相关,但迄今为止,尚未有关于放射诱导的淋巴管扩张产生临床表现的报道。用中链甘油三酯替代饮食中的长链脂肪、补充胰酶以及短期使用土霉素,使临床症状得到显著改善。对于放疗后吸收不良的患者,应考虑肠淋巴管扩张症的可能性。低血清白蛋白和淋巴细胞计数应引起对此可能性的关注。