Cai Huai-Jie, Wang Han, Cao Nan, Wang Wei, Sun Xi-Xi, Huang Bin
The Fourth Clinical Medicine College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China.
Department of Ultrasound, Zhejiang Hospital, Hangzhou 310013, Zhejiang Province, China.
World J Clin Cases. 2020 Feb 6;8(3):577-586. doi: 10.12998/wjcc.v8.i3.577.
Peutz-Jeghers syndrome (PJS) and mesenteric fibromatosis (MF) are rare diseases, and PJS accompanying MF has not been previously reported. Here, we report a case of a 36-year-old man with both PJS and MF, who underwent total colectomy and MF surgical excision without regular follow-up. Two years later, he sought treatment for recurrent acute abdominal pain. Emergency computed tomography showed multiple soft tissue masses in the abdominal and pelvic cavity, and adhesions in the small bowel and peritoneum. Partial intestinal resection and excision of the recurrent MF were performed to relieve the symptoms.
A 36-year-old male patient underwent total colectomy for PJS with MF. No regular reexamination was performed after the operation. Two years later, due to intestinal obstruction caused by MF enveloping part of the small intestine and peritoneum, the patient came to our hospital for treatment. Extensive recurrence was observed in the abdomen and pelvic cavity. The MF had invaded the small intestine and could not be relieved intraoperatively. Finally, partial bowel resection, proximal stoma, and intravenous nutrition were performed to maintain life.
Regular detection is the primary way to prevent deterioration from PJS. Although MF is a benign tumor, it has characteristics of invasive growth and ready recurrence. Therefore, close follow-up of both the history of MF and gastrointestinal surgery are advisable. Early detection and early treatment are the main means of improving patient prognosis.
黑斑息肉综合征(PJS)和肠系膜纤维瘤病(MF)均为罕见疾病,此前尚无PJS合并MF的报道。在此,我们报告一例36岁同时患有PJS和MF的男性患者,其接受了全结肠切除术和MF手术切除,但未进行定期随访。两年后,他因反复出现急性腹痛前来就诊。急诊计算机断层扫描显示腹腔和盆腔内有多个软组织肿块,小肠和腹膜有粘连。为缓解症状,进行了部分肠切除术和复发性MF切除术。
一名36岁男性患者因PJS合并MF接受了全结肠切除术。术后未进行定期复查。两年后,由于MF包裹部分小肠和腹膜导致肠梗阻,患者前来我院治疗。在腹部和盆腔观察到广泛复发。MF已侵犯小肠,术中无法缓解。最后,进行了部分肠切除、近端造口术,并通过静脉营养维持生命。
定期检查是预防PJS病情恶化的主要方法。虽然MF是一种良性肿瘤,但具有侵袭性生长和易于复发的特点。因此,对MF病史和胃肠手术史进行密切随访是可取的。早期发现和早期治疗是改善患者预后的主要手段。