DISCUSSION
The rarity of Waldmann’s Disease in adulthood and its association with other significant medical conditions pose diagnostic challenges. The distinct endoscopic and histological findings, coupled with scintigraphy results, contribute to a comprehensive understanding of this complex case. Currently, the sensitivity and negative predictive value of HSA scintigraphy labeled with 99m Tc make it superior to Alpha 1 antitrypsin clearance (AATC) in the diagnosis of protein-losing enteropathy (PLE). In view of the easy application, lack of adverse effects, wide availability and rapid results, We recommend 99m Tc-labeled HSA scintigraphy as a method initial diagnostic tool for patients with PLE. Finally, it is necessary to integrate clinical evaluation, endoscopic, histological and radiological characteristics, to make an accurate diagnosis of PLE. case4,5. Differential diagnoses and management considerations are discussed.