A Case of Peutz-Jeghers Syndrome in which 51 Polyps were Resected by Surgical and Intraoperative Mucosal Resection

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  • 術中内視鏡を併用し51個のpolyp切除を行ったPeutz-Jeghers syndromeの1例
  • 症例 術中内視鏡を併用し51個のpolyp切除を行ったPeutz-Jeghers syndromeの1例
  • ショウレイ ジュッチュウ ナイシキョウ オ ヘイヨウ シ 51コ ノ polyp セツジョ オ オコナッタ Peutz-Jeghers syndrome ノ 1レイ

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Abstract

The patient was a 35-year-old female with a past history of small bowel resection at the age of 2 and 17 years for small bowel intussusception. One year ago, she was diagnosed as having multiple colonic polyps, but did not present herself for further follow-up. However, she visited our hospital with a 3-month history of persistent abdominal pain and increased bowel movements. Abdominal CT revealed multiple small and large intestinal polyps and three lesions of small bowel intussusception, and we suspected Peutz-Jeghers syndrome. Surgery was performed the following day, and five lesions of small bowel intussusception were observed intraoperatively. After reducing the intussusceptions, intraoperative endoscopy was performed via a small incision in the small bowel. While relatively large polyps were removed by surgical resection, smaller polyps were harvested endoscopically. A total of 51 polyps were resected without small bowel resection. Histopathology confirmed the diagnosis of Peutz-Jeghers syndrome, with no evidence of malignancy in any of the polyps. Cooperation between the gastroenterologist and surgeon is very important from the point of view of small bowel preservation in patients with Peutz-Jeghers syndrome.

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