Which of the following is NOT listed as a contributor to secondary lymphangiectasia?

• A. Bacterial enteritis
• B. IBD
• C. Neoplasia
• D. Right-sided CHF

Answer: (A)

Secondary lymphangiectasia arises when the gut’s lymphatic drainage is blocked or overwhelmed, causing dilation of the intestinal lacteals and leakage of lymph into the lumen, which leads to protein-losing enteropathy. Conditions that obstruct lymphatics or raise lymphatic pressure are classic contributors: neoplasia can physically block lymphatic channels; inflammatory diseases like IBD chronically inflame and damage the lymphatic vessels; and right-sided heart failure raises venous and tissue edema, including in the intestines, promoting lymphatic dilation. Bacterial enteritis, while it causes intestinal inflammation, does not typically create the obstructive or pressure-related changes in the lymphatics that drive secondary lymphangiectasia, so it isn’t usually listed as a contributor.