Endoscopically, the villi of the small bowel in intestinal lymphangiectasia typically appear white and may be swollen. Less commonly, tiny white spots are visible in the mucosa. The whitish discoloration of the villi is caused by chylomicrons, which accumulate in and obstruct the dilated lymphatic capillaries. These changes can also be demonstrated histologically. Lymphangiectasia is characterized endoscopically as localized, patchy, or diffuse. Diffuse lymphangiectasia causes the mucosa to appear “snow-covered” or “dusted with powdered sugar” at endoscopy. Functional lymphangiectasia is dependent on food intake and appears to have no pathologic significance. Primary intestinal lymphangiectasias is a very rare hereditary disease with severe exudative enteropathy Secondary lymphangiectasia is an accompanying feature of many different underlying intestinal and extraintestinal diseases of inflammatory, malignant, iatrogenic origin or as part of a syndrome.