title: A case of recurrent gastrointestinal bleeding and protein-losing gastroenteropathy.
abstract: BACKGROUND
  A 40-year-old male with pentalogy of Fallot (a congenital heart defect with five anatomical components) presented with recurrent gastrointestinal bleeding. He had recently recovered from a heart operation, which was performed to reconstruct the right ventricular outflow tract.
  
  
  METHODS
  Laboratory tests and absorption tests, esophagogastroduodenoscopy, capsule endoscopy, human serum albumin scintigraphy, lymphoscintigraphy, CT and abdominal lymph-node histology.
  
  
  METHODS
  Intestinal lymphangiectasia with concurrent protein-losing gastroenteropathy and recurrent gastrointestinal bleeding. MANAGEMENT Despite a low-fat diet and surgical suturing of multiple small-bowel ulcerations the gastrointestinal bleeding continued. Serum albumin levels remained very low and severe lymphedema occurred. Unfortunately, the patient developed severe sepsis and died of multiple organ failure.
authors.affiliation: Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC 27599, USA. hherf@med.unc.edu
authors.forename: Hans
authors.initials: H
authors.lastname: Herfarth
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Hofstädter
authors.forename: Stefan
authors.initials: S
authors.lastname: Feuerbach
authors.forename: Hans
authors.initials: H
authors.lastname: Jürgen Schlitt
authors.forename: Jürgen
authors.initials: J
authors.lastname: Schölmerich
authors.forename: Gerhard
authors.initials: G
authors.lastname: Rogler
mesh_terms: D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D018752:Diet, Fat-Restricted; D013505:Digestive System Surgical Procedures; D016099:Endoscopy, Gastrointestinal; D017809:Fatal Outcome; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000175:diagnosis / Q000178:diet therapy; D006471:Gastrointestinal Hemorrhage / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007583:Jejunum / Q000473:pathology; D008201:Lymphangiectasis, Intestinal / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D008209:Lymphedema / Q000209:etiology; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology; D011504:Protein-Losing Enteropathies / Q000150:complications* / Q000175:diagnosis / Q000178:diet therapy; D011877:Radionuclide Imaging; D012008:Recurrence