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

Jeremy Stewart1, Nathan R Fleishman2, Vincent S Staggs3

  • 1Division of Pediatric Gastroenterology, University of Texas Southwestern Medical Center, Children's Medical Center, Dallas, TX 75235, USA.

Children (Basel, Switzerland)
|October 28, 2023
PubMed

Insights

Pediatric Peutz-Jeghers Syndrome (PJS) patients often have small intestinal polyps concentrated in the proximal area. Male gender and older age correlate with a higher polyp burden, manageable with enteroscopy.

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.

Keywords:
Peutz–Jeghers syndromeendoscopypediatric disorderspolyposissmall bowel

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