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A 13-year-old boy was diagnosed as having intestinal capillariasis by gastroduodenoscopy. He presented with a 10-month history of chronic abdominal pain and diarrhea. The boy had stayed in central Thailand and had eaten uncooked fish and raw shellfish. Gastroduodenoscopy showed normal jejunal mucosa although histology revealed flattened villi, crypt proliferation, acute inflammation, and eosinophilic granulomata. An egg of Capillaria philippinensis was also seen. The child was treated with mebendazole for 30 days. He had gained six kilograms by the time of his last follow-up.

We report the case of a 63-year-old male hospitalised for chronic diarrhoea and weight loss of 11 kg within 2 years. The symptoms began after a trip to Thailand. Various investigations were negative and led to the assumption of tropical sprue, which was treated with tetracycline. Within 4 months the malabsorption deteriorated and the patient was readmitted with severe electrolyte imbalance. CT-scan of the abdomen revealed a thickened intestinal wall in the jejunum. Diagnostic laparotomy was performed and, surprisingly, revealed chylascites. Histology in a segment of the jejunum demonstrated intestinal lymphangiectasias as the cause of the malabsorption. These intestinal lymphangiectasias were most probably the sequela of radiotherapy 30 years earlier for testicular teratocarcinoma. Symptomatic therapy with middle chain triglycerides brought about substantially improvement.