Double Balloon Enteroscopy in a Pregnant Woman with Peutz-Jeghers Syndrome
Mesut Akarsu1, Soner Onem1, Zarni Htway1
1Department of Gastroenterology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
Insights
Peutz-Jeghers syndrome patients can safely undergo double balloon enteroscopy during pregnancy. This procedure successfully removed obstructive polyps, preventing complications in a pregnant patient.
Area of Science:
- Gastroenterology
- Genetics
Background:
- Peutz-Jeghers syndrome (PJS) is an inherited disorder causing hamartomatous polyps and mucocutaneous pigmentation.
- Polyps commonly occur in the small intestine, particularly the jejunum, posing risks of obstruction and intussusception.
Observation:
- A pregnant woman with PJS and prior intestinal surgery presented with concerning polyp burden.
- Termination was initially advised due to potential pregnancy complications from polyps.
Findings:
- Double balloon enteroscopy was successfully performed in the second trimester of pregnancy.
- Large, potentially obstructive polyps were removed, and post-polypectomy bleeding was managed effectively.
- This represents the first reported instance of double balloon enteroscopy during pregnancy for PJS management.
Implications:
- Double balloon enteroscopy is a viable option for managing PJS-related polyps during pregnancy.
- The procedure requires experienced endoscopists in specialized centers due to inherent risks.
- Timely intervention can prevent serious complications in pregnant PJS patients.
Abstract:
Peutz-Jeghers syndrome is an autosomal dominant disorder characterised by multiple hamartomatous polyps and muco-cutaneous pigmentation. Most polyps are found in the small intestine, especially in the jejunum. Enteroscopy with polypectomy is a reliable method to prevent polyp-related complications. A pregnant woman, who was diagnosed as a case of Peutz-Jeghers syndrome with a history of intestinal resection, was admitted to our clinic. Termination was recommended to the patient due to the possibility of polyps, causing obstruction during pregnancy. She underwent double balloon enteroscopy in the second trimester. Large polyps that could cause intussusception were removed and post-polypectomy bleeding was successfully controlled. This procedure was the first double balloon enteroscopy during pregnancy, reported in the literature. The procedure should be performed by experienced endoscopists, who can cope well with the complications in expert centres, as the procedure carries a high risk. Key Words: Double baloon enteroscopy, Pregnancy, Peutz-Jeghers syndrome, Polyps.
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