A 21-year-old man undergoing appendectomy for acute appendicitis in 2002 was found to have inflammation of the terminal ileum and mesentery. Further fluoroscopy of the small intestine showed a nodular lesion at the terminal ileum, but no other abnormalities were seen. He was followed up without definitive diagnosis as an outpatient and admitted for acute abdomen presenting lower abdominal pain and high fever in 2005. Nil per os and antibiotics administration relieved symptoms, but a mesentery tumor was not ruled out in imaging modalities necessitating surgery. Cystic lesions at the terminal ileum and mesentery necessitated partial ileal resection. Pathologically, lymph ducts were dilated, yielding a definitive diagnosis of intestinal lymphangiectasia.
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