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Query: UMLS:C0000727 (acute abdomen)
 3,084 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The natural history of Peutz-Jeghers syndrome (PJS) is characterized by gastrointestinal complications (occlusion, invagination or bleeding), often the first clinical manifestation in young patients. Surgical treatment consists of treating the complication, exploring the bowel and cleaning out all polyps to prevent further emergency operations at brief intervals. For this purpose both the laparotomic and laparoscopic approaches have been proposed, especially in young patients. A 15-year-old girl was admitted for investigation of colicky abdominal pains. When she was 5 years old, PJS was diagnosed. On admission to our department, the patient underwent emergency esophagogastroduodenoscopy and colonoscopy, both negative. At 24 hours after admission peritonitis developed. Given her clinical history, we rejected the laparoscopic approach proposed at admission and decided for an open laparotomy. Laparotomy disclosed a long jejunoileal invagination that caused irreversible ischemic damage of the bowel. We resected about 130 cm of the ileum and did an end-to-end ileo-ileal anastomosis. Meticulous palpation and transillumination of the residual bowel identified no other polyps. In young patients with acute abdomen and with proven or suspected PJS instead of laparoscopy, open laparotomy is a unique occasion to explore the residual bowel thoroughly, manually and, if possible, endoscopically.
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PMID:Acute abdomen in a 15-year-old patient with Peutz-Jeghers syndrome. Surgical approach. 1269 4

Adult intussusception is rare and is almost always associated with a lead point. Polyposis syndromes are a common cause of adult intussusceptions, with polyps acting as lead points. Peutz-Jeghers syndrome is associated with benign hamartomatous polyps and mucocutaneous pigmentation. Although hamartomatous polyps are not premalignant, there is an increased risk of gastrointestinal and non-gastrointestinal malignancy, most commonly involving the small bowel. Most patients with Peutz-Jeghers syndrome with acute abdomen are diagnosed to have intussusceptions, mostly of the enteroenteric type. Colocolic intussusceptions are rare in Peutz-Jeghers syndrome. To the best of our knowledge, synchronous colocolic intussusception in association with Peutz-Jeghers syndrome has not been previously reported. Here we present a case of malignant jejunal mass and synchronous colocolic intussusceptions in a patient with Peutz-Jeghers syndrome.
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PMID:A rare case of synchronous colocolic intussusception in association with Peutz-Jeghers syndrome. 3036 96