title: Evidence for medium chain triglycerides in the treatment of primary intestinal lymphangiectasia.
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.
  
  
  OBJECTIVE
  The aim was to review the evidence for medium chain triglycerides as a therapeutic option in patients with primary intestinal lymphangiectasia.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatric Surgery, King's College Hospital, London, United Kingdom. ashishdesai@doctors.org.uk
authors.forename: A P
authors.initials: AP
authors.lastname: Desai
authors.forename: B H
authors.initials: BH
authors.lastname: Guvenc
authors.forename: R
authors.initials: R
authors.lastname: Carachi
mesh_terms: D002648:Child; D002675:Child, Preschool; D004041:Dietary Fats / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008201:Lymphangiectasis, Intestinal / Q000178:diet therapy* / Q000401:mortality*; D008297:Male; D016896:Treatment Outcome; D014280:Triglycerides / Q000627:therapeutic use*
chemical_list: D004041:Dietary Fats; D014280:Triglycerides