©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
Small bowel lymphatic malformation: Clinical presentation and a comprehensive literature review
Harbi Khalayleh, Raneem Bader, Muhannad Abu Arafeh, Qasim Odeh, Betty Rogalsky, Riham Imam, Abed Khalaileh, Ashraf Imam
Harbi Khalayleh, Department of Surgery, Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
Raneem Bader, Department of Surgery, Faculty of Health and Science, Samson Assuta Ashdod University Hospital, Ben-Gurion University, Beersheba 91120, Southern, Israel
Muhannad Abu Arafeh, Betty Rogalsky, Department of Pathology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
Qasim Odeh, Department of Gastroenterology, Shaare Zedek Medical Center, Jerusalem 91120, Israel
Riham Imam, Department of Radiology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
Abed Khalaileh, Ashraf Imam, Department of Surgery, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
Co-first authors: Harbi Khalayleh and Raneem Bader.
Co-corresponding authors: Abed Khalaileh and Ashraf Imam.
Author contributions: Khalayleh H, Khalaileh A, and Imam A conceptualized and designed the study, created the artwork, supervised, and made critical revisions; Bader R, Abu Arafeh M, Odeh Q, Rogalsky B, and Imam R conducted the literature review, did the analysis, interpretation of data and drafted the original manuscript; Khalayleh H and Bader R contributed equally to this manuscript and are co-first authors; Khalaileh A and Imam A contributed equally to this manuscript and are co-corresponding authors. All authors prepared the draft and approved the submitted version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Ashraf Imam, MD, Department of Surgery, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Kiryat Hadassah, En Kerem, Jerusalem 91120, Israel.
ash_imam04@hotmail.com
Received: August 15, 2025
Revised: October 4, 2025
Accepted: December 23, 2025
Published online: February 24, 2026
Processing time: 175 Days and 13.8 Hours
Small bowel lymphatic malformations are rare benign tumors of the lymphatic system, accounting for < 1% of intra-abdominal lymphatic malformations. They pose diagnostic challenges due to nonspecific presentations and are often misdiagnosed. To analyze clinical features, management, and outcomes of small bowel lymphatic malformations in adults through a case report and scoping review. A 47-year-old female with chronic abdominal pain underwent laparoscopic resection of an ileal lymphatic malformation. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews-guided scoping review of 97 adult cases (1991-2024) was conducted, extracting demographics, diagnostics, management, and outcomes. The cohort included 41 case reports and 2 case series (46% female, mean age 45.6 years), most commonly presenting with abdominal pain (74%), gastrointestinal bleeding (39%), or asymptomatic masses (9%). Lesions were predominantly in the jejunal mesentery (52%), with a mean size of 9.2 cm. Computed tomography identified lesions in 87% of cases, showing multiloculated cystic masses (78%). Surgical resection was the primary treatment (91%), with segmental bowel resection most frequent (65%). Complications occurred in 24% (infections: 13%), and recurrence in 11% (linked to incomplete resection). Complete excision achieved symptom resolution in 93%. Small bowel lymphatic malformations are rare but may cause significant morbidity. Surgical resection is curative, with laparoscopy emerging as a viable approach. Preoperative diagnosis remains challenging; heightened imaging awareness and complete excision are critical to prevent recurrence.
Core Tip: Small bowel lymphatic malformations are rare, benign lymphatic tumors that present diagnostic challenges in adults due to nonspecific symptoms and varied imaging appearances. This report combines a rare ileal lymphatic malformation case with a scoping review of 97 adult cases, highlighting that abdominal pain and gastrointestinal bleeding are the most common presentations. Computed tomography remains the mainstay for detection, but preoperative diagnosis is uncommon. Complete surgical excision, open or laparoscopic, is curative, with recurrence largely linked to incomplete removal. Heightened clinical suspicion, careful imaging interpretation, and radical resection are key to optimal outcomes.
