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Surgery
Small bowel lymphangioma: a multidisciplinary approach to diagnostic uncertainty
  1. Molly Mead Nichols1,
  2. Ruqayya Lockhart2,
  3. Michael Rathbone3,
  4. Nicholas Reading4,
  5. Vinayata Sheshappanavar3 and
  6. John Davies1
  1. 1General Surgery, Whipps Cross University Hospital NHS Trust, London, UK
  2. 2Barking Havering and Redbridge University Hospitals NHS Trust, Romford, London, UK
  3. 3Histopathology, Whipps Cross University Hospital, London, London, UK
  4. 4Radiology, Whipps Cross University Hospital NHS Trust, London, UK
  1. Correspondence to Molly Mead Nichols; mollynichols{at}outlook.com

Abstract

Intra-abdominal lymphangioma, a rare benign lymphatic malformation resulting from an obstruction to lymphatic channels, often has non-specific clinical manifestations. Low incidence rates of this condition, paired with its unusual presentation and ambiguous radiological appearance, commonly lead to diagnostic uncertainty. This pathology can result in significant morbidity and mortality, emphasising the need to achieve early diagnosis and management despite these challenges.

Here, we discuss a case of a young woman with a small bowel lymphangioma presenting with abdominal pain and explore the difficulties and successes throughout this patient’s complex diagnostic and management journey.

This case reinforces the importance of strong multidisciplinary teamwork and communication, as well as the delivery of patient-centred care, when managing patients presenting with non-specific clinical signs and symptoms. The patient’s perspective highlights the impact such uncertainty can have on the patient experience, emphasising the importance of holistic patient management, considering a patient’s psychological as well as physiological needs.

  • General surgery
  • Gastrointestinal surgery
  • Radiology
  • Clinical diagnostic tests
  • Immunohistochemistry

https://doi.org/10.1136/bcr-2024-261671

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    Footnotes

    • X @M_M_Nichols

    • Contributors The guarantor is JD. The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams, and critical revision for important intellectual content: MMN, MR, RL (patient), NR, VS and JD. The following authors gave the final approval of the manuscript: MMN, MR, RL, NR, VS and JD.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.