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Massive intussusception caused by a solitary Peutz-Jeghers type hamartomatous polyp

V Kalliakmanis1, I Perysinakis2, K Koutsouvas1

  • 1Surgical Department, General Hospital of Agrinio , Agrinio, Aitoloakarnania , Greece.

Annals of the Royal College of Surgeons of England
|February 28, 2018
PubMed

Insights

Intussusception in adults is rare and difficult to diagnose. A 16-year-old presented with jejunojejunal intussusception caused by a Peutz-Jeghers type polyp, successfully treated with surgery.

Area of Science:

  • Gastroenterology and Surgical Oncology

Background:

  • Intussusception is an uncommon cause of intestinal obstruction in adults, often presenting with nonspecific symptoms that challenge preoperative diagnosis.
  • Hamartomatous polyps, such as those associated with Peutz-Jeghers syndrome, can lead to intussusception, though this is rare in adults.

Observation:

  • A 16-year-old female experienced jejunojejunal intussusception near the duodenojejunal junction, with a significant 50 cm necrotic intussusceptum.
  • This presentation was the initial manifestation of an underlying intestinal polyp.

Findings:

  • Surgical intervention involving enterectomy and end-to-end anastomosis successfully resolved the intussusception.
  • The patient's postoperative recovery was uneventful.

Implications:

  • This case highlights the importance of considering rare causes like hamartomatous polyps in adult intussusception.
  • Further gastroenterological and genetic evaluation is crucial to confirm or exclude Peutz-Jeghers syndrome in affected individuals.

Keywords:
Intestinal obstructionIntussusceptionPeutz-Jeghers syndromePolyp

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