FAT-ABSORPTION IN PATIENTS WITH FUNCTIONAL INTESTINAL LYMPHANGIECTASIA AND LYMPHANGIETIC CYSTS

Nine patients with endoscopically identified dilated lacteals of the d uodenum were studied for evidence of pathologic intestinal lymphangiec tasia. Three of the nine patients also had lymphangietic cysts in asso ciation with dilated lacteals. Duodenal biopsies, laboratory data, and imaging studies were performed in each patient. In addition, a C-14 t riolein fat absorption study was performed to assess subclinical malab sorption. Biopsies revealed dilated lymphatic channels in all patients , but laboratory studies failed to suggest intestinal losses of protei n or fat, and radiographic abdominal imaging failed to define any of t he causes of secondary lymphangiectasia. Eight of the nine patients ha d adequate fat absorption as measured by the C-14 triolein breath test . Our data suggest that patients with incidentally discovered dilated lacteals and no clinical evidence of malabsorption may have a function al intestinal lymphangiectasia. Follow-up endoscopy probably is not wa rranted in this population.