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Acta pediátrica de México

versión On-line ISSN 2395-8235versión impresa ISSN 0186-2391

Resumen

UGALDE-RESANO, Rodrigo et al. Conservative surgical treatment in a patient with jejunal-jejunal intussusception secondary to Peutz-Jeghers syndrome. Case rport. Acta pediatr. Méx [online]. 2018, vol.39, n.3, pp.244-249. ISSN 2395-8235.  https://doi.org/10.18233/apm39no3pp244-2491615.

Introduction:

Peutz-Jeghers syndrome is an uncommon autosomal dominant disease, characterized by mucocutaneous hyperpigmentation and gastrointestinal polyps, which are the cause of recurrent intestinal obstructions, secondary to invagination. This case provides evidence to consider more conservative surgical treatments and prevent these patients from being constantly subjected to extensive bowel resections, which in many cases, can condition short bowel disease.

Case presentation:

A 13-year-old female patient who came to the emergency room with acute abdominal pain due to intestinal obstruction secondary to jejuno-jejunal intussusception. 7 years ago, the patient reported similar clinical manifestations that solved spontaneously. Physical examination showed hyperpigmented lesions on the lower lip, and microcytic hypochromic anemia; Peutz-Jeghers syndrome was established. Intestinal intussusception was evidenced by computed axial tomography of the abdomen, so exploratory laparotomy was performed, with the finding of two hamartomatous polyps 2 and 3 cm in diameter at 15 cm of the Treitz ligament. Intestinal intussusception was resolved with subsequently, enterotomy and polypectomy. Other alterations were ruled out by trans-operative enteroscopy. At the resolution of clinical manifestations, the patient was discharged from the hospital in good clinical conditions.

Conclusion:

Intestinal intussusception in adolescents is an exceptional situation, which requires a high index of suspicion for polysposis diseases. We present a case of intestinal intussusception, successfully resolved with conservative surgical treatment, without requiring intestinal resections, which can condition short bowel syndrome in the long-term, one of the major problems these patients face.

Palabras llave : Peutz-Jeghers; gastrontestinal polyps; recurrent intestinal obstructions; acute abdominal pain; jejuno jejunal; adolescents.

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