Massive intussusception caused by a solitary Peutz-Jeghers type hamartomatous polyp

Ann R Coll Surg Engl. 2018 Apr;100(4):e91-e93. doi: 10.1308/rcsann.2018.0019. Epub 2018 Feb 27.

Abstract

Intussusception is a rare cause of intestinal obstruction in adults and represents a diagnostic challenge for the surgeon. In the majority of cases, presenting symptoms are not specific, making preoperative diagnosis difficult. Several medical conditions may cause intestinal intussusception. We present the case of a 16-year-old female patient with intussusception due to a hamartomatous Peutz-Jeghers type polyp. This is an extremely rare case in which the first manifestation of the intestinal polyp was jejunojejunal intussusception very close to the duodenojejunal junction, with a necrotic intussusceptum about 50 cm long. The patient was treated successfully with enterectomy and end-to-end anastomosis. Postoperative course was uneventful and the patient is currently under gastroenterological and genetic investigation to exclude the diagnosis of Peutz-Jeghers syndrome.

Keywords: Intestinal obstruction; Intussusception; Peutz-Jeghers syndrome; Polyp.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Abdominal Pain / surgery
  • Adolescent
  • Anastomosis, Surgical
  • Anorexia / etiology
  • Diarrhea / etiology
  • Digestive System Surgical Procedures / methods
  • Female
  • Hamartoma / complications*
  • Hamartoma / surgery
  • Humans
  • Intestinal Polyps / complications*
  • Intestinal Polyps / surgery
  • Intussusception / etiology
  • Intussusception / pathology
  • Intussusception / surgery*
  • Jejunal Diseases / complications*
  • Jejunal Diseases / surgery
  • Jejunum / pathology*
  • Jejunum / surgery
  • Laparotomy / methods
  • Necrosis
  • Peutz-Jeghers Syndrome / diagnosis
  • Peutz-Jeghers Syndrome / genetics
  • Rare Diseases / etiology
  • Rare Diseases / surgery*
  • Vomiting / etiology