Remission of protein-losing enteropathy after nodal lymphoma treatment in a patient with primary intestinal lymphangiectasia.

Remission of protein-losing enteropathy after nodal lymphoma treatment in a patient with primary intestinal lymphangiectasia.
Eur J Gastroenterol Hepatol. 2005 Dec

Laharie D,
Degenne V,
Laharie H,
Cazorla S,
Belleannee G,
Couzigou P,
Amouretti M.
Service d'Hepatogastroenterologie, Hopital Haut-Leveque, Pessac, France. david.laharie@chu-bordeaux.fr

Primary intestinal lymphangiectasia (PIL), so-called Waldmann's disease, is an uncommon condition, characterized by dilated intestinal submucosal and subserosal lymphatics of the gastrointestinal tract. Protein-losing enteropathy is the most common manifestation of this supposed congenital disease. Since the initial description in 1961, 11 cases of lymphoma have been reported suggesting that PIL predisposes to lymphoma. Here, we report the first case of primary nodal location lymphoma during PIL with recovery of the protein-losing enteropathy after its treatment by radiochemotherapy.

Lippincott Williams & Wilkins

Capsule Endoscopy in the Pediatric Patient

Capsule Endoscopy in the Pediatric Patient
Curr Treat Options Gastroenterol. 2006 Sep

Seidman EG,
Dirks MH.
Division of Gastroenterology, Montreal Children's Hospital, 2300 Tupper Street, Room D562, Montreal, Quebec H3H 1P3, Canada. digestivelab@hotmail.com.

Wireless capsule endoscopy represents an extraordinary technical innovation in diagnostic gastrointestinal endoscopy. As in adult patients, it opens new horizons that permit an accurate and noninvasive approach to identifying occult lesions in the small bowel in children and adolescents. A limitation in the pediatric age group is the size of the capsule, precluding its use in infants and small toddlers.

In children unable to swallow the capsule, "front loading" the gastroscope to introduce it into the duodenum is a suitable alternative approach. Capsule endoscopy is highly useful to evaluate for inflammatory changes in patients suspected to have small bowel Crohn's disease in whom conventional imaging failed to confirm the diagnosis. It is now the method of first choice to assess for small bowel polyps or tumors, to find a source of blood loss in obscure intestinal bleeding, and for undiagnosed malabsorptive conditions such as intestinal lymphangiectasia.

Capsule retention is the one major potential adverse effect of capsule endoscopy. In patients suspected to have a small bowel stenosis, consideration should be given to using the patency capsule prior to using the real videocapsule so as to decrease the risk of capsule retention.

Gastroenterology