Small intestinal mucosal abnormalities using video capsule endoscopy in Intestinal lymphangiectasia

Abstract Objectives To disclose the video capsule endoscopy (VCE) characteristics of small intestinal mucosal abnormalities in patients with intestinal lymphangiectasia (IL), and to investigate the relationship between clinical and VCE characteristics. Methods Consecutive patients with IL underwent the VCE were enrolled into the retrospective study. The cases were classified into white villi group and non-white villi group according to mucosal abnormalities detected by VCE. Clinical and endoscopic characteristics were investigated and analyzed. Results A total of 98 patients with IL with a median onset age of 26.3 ± 19.2 years were included. VCE disclosed the following small intestinal lesions: (i) white villi type (57/98, 58.2%), i.e.: white-tipped or granular villi, white nodular villi or plaques; (ii) non-white villi type (41/98, 41.8%), i.e.: diffused low and round villi; (iii) complications (46/98, 46.9%), i.e.: bleeding, ulcers, protruding or vesicular-shaped lesions, stenosis and lymphatic leakage. 58.2% (57) and 41.8% (41) of cases were classified into white villi and non-white villi group respectively. The percentage of chylothorax in white villi group was significantly lower than non-white villi group (12/57 vs. 19/41, p = 0.008). In VCE, there were no significant differences in involved segments and total detected rate of complications between white villi and non-white villi groups (p > 0.05), while the detected rate of lymphatic leakage in white villi group was significantly higher than non-white villi group (31.6% vs. 12.2%, p = 0.026). Conclusions Our study identified the entire small intestinal mucosal abnormalities of IL by VCE, especially in endoscopic complications. IL has specific VCE abnormalities in addition to classical endoscopic findings.