Small Intestinal Polyp Burden in Pediatric Peutz-Jeghers Syndrome Assessed through Capsule Endoscopy: A Longitudinal...

Area of Science:

• Gastroenterology and Hepatology
• Pediatric Gastroenterology
• Genetics and Hereditary Diseases

Background:

• Peutz-Jeghers Syndrome (PJS) management in children primarily aims to prevent intussusception caused by small intestinal (SI) polyposis.
• Accurate assessment of polyp burden is crucial for effective therapeutic strategies in pediatric PJS.
• Video Capsule Endoscopy (VCE) is utilized for SI polyps in children, but detailed characterization of polyp burden is limited.

Purpose of the Study:

• To analyze the characteristics and burden of small intestinal polyps in pediatric patients with Peutz-Jeghers Syndrome.
• To identify factors influencing polyp burden and distribution in this specific pediatric population.

Main Methods:

• Retrospective analysis of VCE studies conducted between 2010 and 2020 in pediatric PJS patients.
• Data collection included demographic, clinical information, and VCE findings, reviewed by three independent specialists.
• Polyp burden variables were modeled using linear mixed models, accounting for patient and study characteristics.

Main Results:

• The study included 15 pediatric PJS patients, with polyp counts generally under 30 and largest polyp size below 20 mm.
• Polyp distribution predominantly favored the proximal small intestine (77%) over the distal (66%).
• Increased polyp burden was observed in males and associated with older age; Double Balloon Enteroscopy correlated with reduced polyp burden.

Conclusions:

• Pediatric PJS patients exhibit a polyp burden concentrated in the proximal small intestine, with polyps generally amenable to enteroscopic resection.
• Male gender and older age are associated with a greater polyp burden in pediatric PJS.
• Findings support tailored endoscopic interventions based on polyp burden assessment in pediatric PJS management.