Lymphatic Leakage in Protein-losing enteropathy (PLE) Video

This video illustrates lymphatic protein-losing enteropathy (PLE), the loss of serum proteins from the digestive track. In many cases, this loss of protein is due to abnormalities in lymphatic flow. 
In children and adults with PLE, channels originating in the intestine or originating in the liver and connecting to the intestine begin to flow in the opposite direction, creating leaks in the intestinal wall. The duodenum (part of the small intestine) appears to be especially susceptible to this abnormality. 
As lymphatic fluid spills in, there is no way for the body to absorb it. This fluid loss results in an abnormally low level of albumin (a protein made by the liver), electrolytes, coagulants and even T-cells. It can also lead to diarrhea and edema.


Lymphatic Leakage in Protein-losing enteropathy (PLE) Video

Brittany Bennett, MA: This animation shows normal lymphatic anatomy and flow. Lymphatic fluid flows from the lower extremities -- the liver and intestine -- to the thoracic duct, which is the main channel for lymphatic drainage. In most people, the thoracic duct drains into the subclavian vein on the left side.

Now we see lymphatic flow in patients with Protein Losing Enteropathy or PLE. Lymphatic fluid from the liver, intestine, lower extremities, or a combination of any of these, can flow backwards and leak into the intestinal lumen.

Most commonly, this occurs from the liver into the duodenum, which is the first part of the small intestine. In patients with PLE, we see symptoms such as low albumin levels in the blood, edema or swelling, and diarrhea. We can diagnose PLE with lymphatic imaging. There are multiple treatment options for PLE, including medical management, minimally invasive interventions and surgical interventions.

Our team will determine the best intervention for you or your child based on your diagnosis and imaging.

Related Centers and Programs: Jill and Mark Fishman Center for Lymphatic Disorders