Bhattacharya Sayantan, Mahapatra Sunondo R, Nangalia Ramlal, Palit Amitabh, Morrissey John R, Ruban Ernie, Jadhav Vijay, Mathew George
George Eliot Hospital, Nuneaton, CV10 7DJ, UK.
J Med Case Rep. 2010 Feb 8;4:44. doi: 10.1186/1752-1947-4-44.
Peutz-Jeghers syndrome (PJS) is a rare familial disorder characterised by mucocutaneous pigmentation, gastrointestinal and extragastrointestinal hamartomatous polyps and an increased risk of malignancy. Peutz-Jeghers polyps in the bowel may result in intussusception. This complication usually manifests with abdominal pain and signs of intestinal obstruction.
We report the case of a 24-year-old Caucasian male who presented with melaena. Pigmentation of the buccal mucosa was noted but he was pain-free and examination of the abdomen was unremarkable. Upper gastrointestinal endoscopy revealed multiple polyps. An urgent abdominal computed tomography (CT) scan revealed multiple small bowel intussusceptions. Laparotomy was undertaken on our patient, reducing the intussusceptions and removing the polyps by enterotomies. Bowel resection was not needed.
Melaena in PJS needs to be urgently investigated through a CT scan even in the absence of abdominal pain and when clinical examination of the abdomen shows normal findings. Although rare, the underlying cause could be intussusception, which if missed could result in grave consequences.
黑斑息肉综合征（PJS）是一种罕见的家族性疾病，其特征为黏膜皮肤色素沉着、胃肠道和胃肠道外错构瘤性息肉以及恶性肿瘤风险增加。肠道中的黑斑息肉可能导致肠套叠。这种并发症通常表现为腹痛和肠梗阻体征。
我们报告一例24岁白种男性患者，其表现为黑便。发现颊黏膜有色素沉着，但他无疼痛，腹部检查无异常。上消化道内镜检查发现多个息肉。紧急腹部计算机断层扫描（CT）显示多个小肠肠套叠。对我们的患者进行了剖腹手术，通过肠切开术复位肠套叠并切除息肉。无需进行肠切除。
即使在没有腹痛且腹部临床检查结果正常的情况下，PJS患者出现黑便也需要通过CT扫描进行紧急检查。虽然罕见，但潜在原因可能是肠套叠，如果漏诊可能会导致严重后果。
