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Management of small-bowel polyps in Peutz-Jeghers syndrome by using enteroclysis, double-balloon enteroscopy, and

Naoki Ohmiya1, Masanao Nakamura, Hiroyuki Takenaka

  • 1Department of Gastroenterology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.

Gastrointestinal Endoscopy
|October 26, 2010
PubMed

Insights

Videocapsule enteroscopy (VCE) and double-balloon enteroscopy (DBE) are effective for managing Peutz-Jeghers syndrome (PJS) small-bowel polyps. VCE may replace barium studies for surveillance based on polyp growth rates.

Area of Science:

  • Gastroenterology
  • Medical Diagnostics
  • Genetics

Background:

  • Peutz-Jeghers syndrome (PJS) management of small-bowel polyps using fluoroscopic enteroclysis (FE), double-balloon enteroscopy (DBE), and videocapsule enteroscopy (VCE) requires further evaluation.
  • The optimal diagnostic and surveillance strategies for PJS-related gastrointestinal polyposis are not fully established.

Purpose of the Study:

  • To assess the diagnostic utility of FE, VCE, and DBE in patients with PJS.
  • To determine the polyp growth rate in PJS patients.
  • To evaluate the histological findings of resected small-bowel polyps.

Main Methods:

  • A single-center retrospective study involving 18 consecutive PJS patients (June 2003–January 2010).
  • Comparison of polyp detection rates among FE, VCE, and DBE.
  • Histological analysis of resected polyps and calculation of polyp growth rates.

Main Results:

  • VCE demonstrated a higher total enteroscopy rate (89%) compared to DBE (52%).
  • Histology revealed adenoma or adenocarcinoma in 30% of polyps >20 mm, versus 1.3% for polyps ≤20 mm.
  • Small-bowel polyps >10 mm and colorectal polyps >5 mm were independent predictors of small-bowel polyp growth rate.

Conclusions:

  • DBE and VCE are valuable tools for managing small-bowel polyps in PJS.
  • VCE shows promise as a replacement for barium examinations in PJS polyp surveillance.
  • Polyp size and presence of colorectal polyps are key factors in predicting small-bowel polyp growth rate.
Abstract

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