Experience of Small Bowel Polypectomy in a Pediatric Peutz–Jeghers Syndrome Patient Combined With Intraoperative Endoscopy After Repair of Intussusception by Double-Balloon Enteroscopy

Abstract

We report a case of Peutz–Jeghers syndrome treated surgically combined with intraoperative endoscopy after repair of intussusception caused by a hamartomatous polyp using double-balloon enteroscopy. The patient was an 11-year-old boy whose pigmentation in his lips and fingers had been noticed since infancy and who complained of intermittent abdominal pain from one year ago. Examination revealed multiple polyps from the stomach to the rectum, and the polyp caused intussusception in the ileum. The intussusception was repaired by double-balloon enteroscopy but the polyp was too large to be resected endoscopically. Thus, surgical resection of the polyp and intraoperative endoscopy for the other remaining polyps were performed. From our experience, we thought that early polypectomy and prevention of intussusception by regular surveillance are necessary and can lead to the avoidance of surgical resection. Even when surgery is required, intraoperative endoscopy also reduces surveillance, which leads to the QOL improvement of pediatric patients with Peutz–Jeghers syndrome.