Endoscopic resection of Peutz-Jeghers polyps throughout the small intestine at double-balloon enteroscopy without laparotomy

Gastrointest Endosc. 2005 Jan;61(1):140-7. doi: 10.1016/s0016-5107(04)02457-5.

Abstract

Background: Small-bowel enteroscopy with the double-balloon method was developed to improve access to the small intestine. This study evaluated the usefulness of this method for the resection of small-intestinal Peutz-Jeghers polyps.

Methods: Two patients with Peutz-Jeghers syndrome underwent nonsurgical double-balloon enteroscopic resection of polyps throughout the small intestine.

Observations: Multiple polyps in the jejunum were successfully resected via the oral route, as were the polyps in the ileum via the anal route. All 18 polyps (10-60 mm in size) were resected without subsequent bleeding or perforation. Histopathologically, 3 large polyps (>30 mm diameter) were hamartomas with adenomatous components.

Conclusions: Double-balloon enteroscopy was safe and useful for the diagnosis and the treatment of Peutz-Jeghers polyps throughout the small intestine. Double-balloon enteroscopic polypectomy might preclude complications of Peutz-Jeghers syndrome, including intussusception, bleeding, and tumorogenesis, thereby obviating the need for multiple laparotomies.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Catheterization*
  • Endoscopy, Gastrointestinal / methods*
  • Female
  • Humans
  • Intestinal Polyps / diagnosis
  • Intestinal Polyps / etiology*
  • Intestinal Polyps / therapy*
  • Intestine, Small*
  • Male
  • Peutz-Jeghers Syndrome / complications*