A Cross-sectional Case-controlled Study on the Significance of Intestinal Lymphangiectasia Incidentally found in the Duodenum on EGD

Background/Aim: Intestinal lymphangiectasia (IL) is associated with co-existing pathology such as autoimmune diseases or tumors. It can also be incidentally found on esophagogastroduodenoscopy (EGD). However, the clinical significance of this finding is still uncertain. The aim of this study is to determine if those with incidental finding of IL on EGD have a higher risk of co-existing pathology. Methods: This is a cross-sectional case-controlled study. A total of 4948 patients underwent EGD. Results: One-hundred and twenty seven of these 4948 patients (2.6%) had histologically confirmed IL (IL group). Seven hundred and six patients without IL on EGD performed in the same session as those with IL were recruited as control (Control group). Twenty-two of the 127 patients (17.3%) in the IL group had co-existing pathology when compared with 54 of the 706 patients (7.6%) in the Control group (p = 0.001). Patients with co-existing pathology were more likely to have IL in the duodenum [22/76 (28.9%) vs. 105/757 (13.9%), p = 0.001], be older in age [median (range) 56 (34-79) years vs. 53 (21-82) years, p = 0.015], have a higher serum erythrocyte sedimentation rate [median (range) 19 (3-108) mm/hr vs. 15 (1-96) mm/hr, p < 0.001)] and to have an elevated serum erythrocyte sedimentation rate [21/76 (27.6%) vs. 56/757 (7.4%), p < 0.001] when compared with patients without co-existing pathology. On multiple analyses, IL in the duodenum [p = 0.036, Odds Ratio 1.043, 95% confidence interval 0.925-1.175] was an independent factor associated with co-existing pathology. Conclusion: Those with IL are more likely to have co-existing pathology.