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Eur J Pediatr Surg 2009; 19(4): 241-245
DOI: 10.1055/s-0029-1216389
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Evidence for Medium Chain Triglycerides in the Treatment of Primary Intestinal Lymphangiectasia

A. P. Desai1 , B. H. Guvenc2 , R. Carachi3
  • 1Department of Pediatric Surgery, King's College Hospital, London
  • 2Department of Pediatric Surgery, Anadolu Medical Center, Kocaeli, Turkey
  • 3Section of Surgical Paediatrics, University of Glasgow, Glasgow,United Kingdom
Further Information

Publication History

received September 24, 2008

accepted after revision February 19, 2009

Publication Date:
15 May 2009 (online)

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Abstract

Primary intestinal lymphangiectasia is an uncommon congenital anomaly. It is an intrinsic abnormality of the intestinal lymphatics system. Over the years, various treatment options such as diuretics, albumin transfusions and a medium chain triglycerides (MCT) diet as well as surgical options such as resection of isolated segments and peritoneal-venous shunts have been used. An MCT diet, which is a low fat, high protein diet, is increasingly used in the management of this anomaly.

Aim: The aim was to review the evidence for medium chain triglycerides as a therapeutic option in patients with primary intestinal lymphangiectasia.

Material and Methods: A literature search was performed and individual case details were extracted. We found 55 cases, of which 3 were from our own institute. The cases were divided in 2 groups: Group A (n=27) consisted of patients treated with MCT, and Group B (n=28) consisted patients not treated with MCT. Cases were analysed for symptomatic response to MCT as well as mortality.

Results: 17 of 27 cases (63%) treated with MCT had complete resolution of symptoms while only 10 of 28 (35.7%) patients in group B showed complete resolution. Mortality for Group A was 1 out of 27 (3.7%), while mortality in group B was 5 of 28 (17.85%) patients.

Conclusion: We conclude that, although an MCT diet is not completely curative in all cases, it does improve the symptoms of primary intestinal lymphangiectasia and reduces mortality. Hence it is a valid option in the paediatric age group.

Key words

nutrition - intestinal lymphangiectasia - medium chain triglycerides - review

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Correspondence

Mr. A. P. DesaiMBBS, MS, MCh, DNB, FEBPS, FRCS 

Department of Pediatric Surgery

King's College Hospital

Denmark Hill

London

United Kingdom

SE5 9RS

Phone: +44/79/1059 06 80

Fax: +44/20/3299 40 21

Email: ashishdesai@doctors.org.uk