Abstract
Ball valve syndrome (BVS) appears with gastric pain, vomiting, and distension caused by the invagination of a gastric polyp into the duodenum. We report a case of BVS in a 6-year-old boy with a characteristic pigmentation of the lips, severe anemia (Hb level 4.6 g/dl) and a family history of Peutz-Jeghers syndrome (PJS), which is characterized by pigmentation of the lips and severe anemia (Hb level, 4.6 g/dl). The patient complained of continual and intermittent abdominal pain and malaise owing to severe anemia, possibly caused by BVS. An enhanced abdominal CT scan showed a large polyp invagination into the duodenum, and esophagogastroduodenoscopy was performed for diagnosis. A cauliflower-like polyp of approximately 50 mm size was detected at the posterior wall of the mid-lower gastric body. The polyp was resected successfully by endoscopic mucosal resection (EMR). In order to remove the polyp from the stomach without laparotomy, it was divided into 10 pieces using a bipolar electrocautery snare. Since new and recurrent polyp growth is common in PJS patients, EMR with bipolar snare division is a useful method of preventing repeated laparotomy procedures in pediatric PJS patients, particularly in those with BVS caused by a large polyp.
