A Case of Peutz-Jeghers Type Polyp in the Small Intestine Which Caused Retrograde Intussusception, Treated by Laparoscopic Surgery

Abstract

A 19-old man admitted to our hospital due to nausea, vomiting, and dehydration. Abdominal CT demonstrated target-shaped thickening of the small intestine suggesting intussusceptotion. Contrast radiography of the small intestine showed the clubbed finger sign suggesting intussusception in third portion of the duodenum. Based on these findings, we conducted laparoscopic surgery. A retrograde intussusception of jejunum with a preceding tumor was present around the Treitz ligament. Manual repositioning was performed under laparoscopic surgery. A tumor about 3cm in diameter was identified. Partial jejunum resection including the tumor and functional anastmosis were also performed under laparoscopic surgery. The polyp was histologically diagnosed as a Peutz-Jeghers polyp. Solitary Peutz-Jeghers polyp was rare. This patient did not have typical mucocutaneous pigmentation or hereditary factors, so that we concluded that this patient had incomplete Peutz-Jeghers syndrome. We report this rare case of the retrograde small intestinal intussusception with Peutz-Jeghers polyp treated by pure-laparoscopic surgery.