1981 Volume 23 Issue 1 Pages 133-141
This report described a case of a 74-year-old male patient with intestinal lymphangiec-tasia of which endoscopic findings of the duodenum using the magnifying endoscope, Olympus GIF-HM (maximal magnifying power x35), were studied. He was admitted to Keio University Hospital because of edema of the legs and hypoalbuminemia (1.8g/dl). Albumin degradation test using 131I-RISA and 131I-PVP test disclosed protein-losing gastroenteropathy. Lymphography showed the hypoplasia of the para-aortal lymphducts. Magnifying endoscopic examination revealed the white villi, scattered white spots and reddened villi especially in the upper part of the duodenal second portion. White villi did not exist homogeneously, with zonal distribution in some parts of the duodenum. Scattered white spots were classified according to the way of existence into: 1 Solitary type 2 Grouping type 1) Linear or zonal type 2) Insular type. White villi and scattered white spots showed various degrees of the depth of white colour. Biopsy specimens obtained fom white spots revealed the lymphangiectasia in the lamina propria of the mucosa. Abnormal olive oil tolerance test and 131I-Triolein test suggested that white villi and scattered white spots might be related to the disturbance of fat absorption.
