P3216 - A Rare Finding of Duodenal Lymphangioma: A Case Report

Urmimala Chaudhuri, DO¹, Krisitina Franklin, BS², Drew Triplett, DO^3
1Wright State University, Centerville, OH; ²Ohio University School of Osteopathic Medicine, Dayton, OH; ³Wright State University, Dayton, OH

Introduction: Lymphangiomas are benign lymphatic tumors that are composed of thin-walled cysts and normally found in the head and neck. About 50% are diagnosed at birth and 90% by 2 years. Therefore, it is an extremely rare diagnosis in adults. We present a rare case of a duodenal lymphangioma in a 61-year-old female, which was incidentally found during an EGD.

Case Description/Methods: A 61-year-old female with a prior history of H. pylori and gastric band surgery (converted to sleeve gastrectomy) presented with abdominal pain, shortness of breath, nausea, and vomiting. Patient was referred to gastroenterology for esophagogastroduodenoscopy (EGD) after multiple ER visits did not reveal remarkable findings. During the EGD, she was noted to have erosive gastritis and notably, a 1-cm raised nodule with whitish plaques proximal to the duodenal papilla. Biopsy results from the duodenal portion confirmed the presence of a lymphangioma ruling out celiac sprue, H. pylori, and other infectious microorganisms. For management, we counseled the patient to continue proton pump inhibitor (PPI) therapy.

Discussion: Lymphangiomas are unusual cystic lesions originating from lymphatic vessels, with a higher incidence observed in the pediatric population. The etiology of lymphangiomas may be associated with factors such as abdominal trauma, inflammation, or previous surgeries. In this case, the patient's history of lap band surgery, later converted to gastric sleeve, is considered a potential contributing factor to the development of the duodenal lymphangioma. Clinical manifestations of duodenal lymphangiomas vary widely, ranging from asymptomatic incidental findings to severe gastrointestinal bleeding and obstructive symptoms. Duodenal lymphangiomas are generally benign and typically do not necessitate treatment unless complicated by infection, hemorrhage, or fistula formation.

The etiology of duodenal lymphangiomas remains incompletely understood, with limited definitive risk factors identified in the medical literature. Clinical presentations are highly diverse, ranging from asymptomatic incidental discoveries to severe gastrointestinal symptoms. Given the intricate clinical nature of duodenal lymphangiomas, a multidisciplinary approach is essential to ensure accurate diagnosis and optimal management.




Disclosures:


Urmimala Chaudhuri, DO¹, Krisitina Franklin, BS², Drew Triplett, DO³. P3216 - A Rare Finding of Duodenal Lymphangioma: A Case Report, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.