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黑斑息肉综合征的罕见表现:一例空肠-空肠套叠和扭转导致小肠梗阻的病例。

Uncommon manifestation of Peutz-Jeghers syndrome: a case of jejuno-jejunal intussusception and volvulus leading to small bowel obstruction.

作者信息

Barhmji Hesham, Alsalehi Abduraboh, Kammasha Ahmad, Alkheder Ahmad

机构信息

General Medicine Department, Faculty of Medicine, Damascus University, Damascus 963, Syria.

General Surgery Department, Maarib General Hospital Authority, Maarib 967, Yemen.

出版信息

J Surg Case Rep. 2024 May 28;2024(5):rjae335. doi: 10.1093/jscr/rjae335. eCollection 2024 May.

Abstract

Peutz-Jeghers syndrome (PJS) is a rare genetic disorder causing gastrointestinal polyps and skin pigmentation. Our case report highlights a unique instance of jejuno-jejunal intussusception associated with PJS in a 28-year-old female patient who presented to the emergency department with colicky abdominal pain, tachycardia, and gastrointestinal symptoms. Physical examination revealed mucocutaneous hyperpigmentation. Imaging studies showed a U-shaped distension in the jejunum with thickening and pneumatosis. Laparotomy revealed a jejuno-jejunal volvulus with intussusception. Surgical resection successfully addressed gangrenous jejunal tissue and ileal polyps. Histopathology confirmed PJS polyps. Postoperatively, the patient recovered well and was discharged. Family history revealed similar skin lesions in her uncle. Our case highlights the need for prompt surgical intervention to address complications associated with PJS and elucidates a unique presentation of PJS involving jejuno-jejunal intussusception and volvulus leading to complete small bowel obstruction. We aim to deepen understanding and prompt discussions on optimal therapeutic strategies.

摘要

黑斑息肉综合征(PJS)是一种罕见的遗传性疾病,可导致胃肠道息肉和皮肤色素沉着。我们的病例报告突出了一名28岁女性患者中与PJS相关的空肠-空肠套叠的独特病例,该患者因绞痛性腹痛、心动过速和胃肠道症状就诊于急诊科。体格检查发现黏膜皮肤色素沉着。影像学研究显示空肠呈U形扩张,伴有增厚和气肿。剖腹手术发现空肠-空肠扭转伴套叠。手术切除成功处理了坏死的空肠组织和回肠息肉。组织病理学证实为PJS息肉。术后,患者恢复良好并出院。家族史显示她的叔叔有类似的皮肤病变。我们的病例强调了对与PJS相关的并发症进行及时手术干预的必要性,并阐明了PJS涉及空肠-空肠套叠和扭转导致完全性小肠梗阻的独特表现。我们旨在加深对最佳治疗策略的理解并促进相关讨论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bcd/11132885/0e7c6791362d/rjae335f1.jpg

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