What ultrasound finding is highly specific for lacteal dilation in lymphangiectasia?

• A. Hyperechoic mucosal striations
• B. Thickened muscularis propria
• C. Free peritoneal fluid
• D. Dilated small bowel loops

Answer: (A)

Lymphangiectasia causes dilation of the intestinal lacteals within the mucosa, and these lipid-filled lymphatics reflect sound waves strongly, producing bright, parallel lines along the mucosal surface. That appearance—hyperechoic mucosal striations—is highly specific for lacteal dilation because it directly represents the dilated lymphatics in the villi, a finding not produced by simple wall thickening, free fluid, or bowel dilation.

The other signs don’t point to dilated lacteals: a thickened muscularis propria suggests deeper wall involvement from inflammation or other processes, not the mucosal lymphatic dilation; free peritoneal fluid can occur with many conditions and isn’t specific; dilated small bowel loops indicate obstruction or ileus rather than lymphatic dilation.