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Laparoscopic-assisted disinvagination and polypectomy for multiple intussusceptions induced by small intestinal
Masaaki Yamamoto1,2, Kazuya Iwamoto3,4, Rei Suzuki3
1Department of Gastroenterological Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan. masa0302g@oici.jp.
Insights
Peutz-Jeghers syndrome (PJS) patients with small intestinal polyps causing intussusception can be treated with laparoscopic-assisted surgery. This minimally invasive approach resected polyps, resolving complications like anemia and obstruction risks.
Area of Science:
- Gastroenterology
- Medical Genetics
- Surgical Oncology
Background:
- Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant disorder.
- Characterized by gastrointestinal hamartomatous polyps and mucocutaneous hyperpigmentation.
- Small intestinal polyps frequently lead to intussusception and bleeding.
Observation:
- A 62-year-old male with deep vein thrombosis and pulmonary embolism presented with PJS.
- Computed tomography revealed small intestinal polyps causing intussusceptions.
- Patient exhibited characteristic PJS features: gastrointestinal polyposis and mucocutaneous pigmentation.
Findings:
- Laparoscopic-assisted surgery was performed after inferior vena cava filter placement.
- Polyps causing intussusception were resected without intestinal resection.
- The patient recovered without complications and was discharged on postoperative day 9.
Implications:
- Laparoscopic-assisted disinvagination and polypectomy is a viable treatment for PJS-related intussusceptions.
- Minimally invasive surgery can effectively manage complications like anemia and prevent future obstruction.
- This approach offers a less invasive alternative to traditional intestinal resection for PJS patients.
Background:
Peutz-Jeghers syndrome (PJS) is a very rare autosomal dominant genetic disorder characterized by hamartomatous polyps in the gastrointestinal tract and hyperpigmentation of the lips, hands, and feet. The hamartomatous polyps in the small intestine often cause intussusception and bleeding.
Case Presentation:
A 62-year-old male was hospitalized for treatment of deep vein thrombosis and pulmonary embolism. In the small intestine, computed tomography showed three small polyps with intussusceptions. Since the patient had gastrointestinal polyposis and pigmentation of his lips, fingers, and toes, he was diagnosed with PJS. After an inferior vena cava filter was placed, he underwent laparoscopic-assisted surgery. The polyps causing intussusception were resected as far as possible without intestinal resection, since they had caused progressive anemia and might cause intestinal obstruction in the future. The patient was discharged from the hospital on postoperative day 9 without complications.
Conclusions:
Laparoscopic-assisted disinvagination and polypectomy is a useful, minimally invasive treatment for multiple intussusceptions caused by small intestinal polyps in patients with PJS.
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