Intestinal intussusception in a child with Peutz?Jeghers syndrome: case report

Ovechkin, Denys, Awuah, Wireko Andrew, Wellington, Jack, Adebusoye, Favour Tope, Moskalenko, Roman, Dmytruk, Serhii, Abdul-Rahman, Toufik and Ovechkina, Yaryna 2023. Intestinal intussusception in a child with Peutz?Jeghers syndrome: case report. Annals of Medicine and Surgery 85 (5) , pp. 2216-2220. 10.1097/MS9.0000000000000675

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Abstract

Introduction and importance: Peutz–Jeghers syndrome (PJS), an uncommon inherited autosomal dominant disorder, is distinguished by mucocutaneous pigmentations, many gastrointestinal hamartomatous polyps, and a higher incidence of gastrointestinal tract, genitourinary, and extracolonic malignancies. Recurrent acute intestinal obstruction, in particular intussusception in the young, is a serious sequalae of PJS. Case presentation: A clinical observation of a 5-year-old patient with a complicated course of PJS is presented. Emphasis on recurring episodes of acute abdomen, clinical diagnosis including polyp histopathology, and surgical management is emphasised. Clinical findings and investigations: While an inpatient, bloodwork demonstrated severe iron deficiency anaemia (haemoglobin 72 g/l, red blood cell 3.1×1012/l) and multiple melanin pigmentations measuring 2–4 mm in size on the lip mucosa during a physical examination. Erosive duodenopathy and polyposis of the stomach were discovered via fibroesophagogastroduodenoscopy (multiple gastric polyps 5–10 mm in size). Acute intussusception of the intestine was discovered by ultrasonography. Interventions and outcome: A mid-median laparotomy was performed alongside manual disinvagination with gut viability intact. Histopathology of excised polyps revealed smooth muscle hyperplasia and Ki67 protein (MIB-1) positivity with small intestinal hamartomatous polyps seen macroscopically. Conservative management was initiated for standard postoperative care and intestinal motility. Patient was discharged 9 days postoperatively. Relevance and impact: Based on literature data, modern ideas concerning aetiology, diagnosis, and management of patients with PJS are considered. Attention is focused on the high risk of developing cancer of various localisation in PJS, recommendations are given for cancer screening and clinical observation of patients with hereditary gastrointestinal syndromes in childhood.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Medicine
Publisher:	Elsevier
ISSN:	2049-0801
Date of First Compliant Deposit:	17 April 2024
Date of Acceptance:	2 April 2023
Last Modified:	17 Apr 2024 15:26
URI:	https://orca.cardiff.ac.uk/id/eprint/167968

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