Endoscopic resection of Peutz-Jeghers polyps throughout the small intestine at double-balloon enteroscopy without laparotomy

Ohmiya, Naoki; Taguchi, Ayumu; Shirai, Kennosuke; Mabuchi, Nobuyuki; Arakawa, Daigo; Kanazawa, Hironobu; Ozeki, Masayasu; Yamada, Masahiro; Nakamura, Masanao; Itoh, Akihiro; Hirooka, Yoshiki; Niwa, Yasumasa; Nagasaka, Tetsuro; Ito, Masafumi; Ohashi, Shinji; Okamura, Shozo; Goto, Hidemi

« Previous Next »Gastrointestinal Endoscopy
Volume 61, Issue 1 , Pages 140-147, January 2005

Endoscopic resection of Peutz-Jeghers polyps throughout the small intestine at double-balloon enteroscopy without laparotomy

Current affiliations: Division of Gastroenterology, Department of Therapeutic Medicine, Department of Laboratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan, Department of Endoscopy, Department of Pathology, Nagoya University Hospital, Nagoya, Japan, Division of Gastroenterology, Department of Internal Medicine, Toyohashi Municipal Hospital, Aichi, Japan

Received 7 June 2004; received in revised form 8 August 2004; accepted 27 September 2004.

Background

Small-bowel enteroscopy with the double-balloon method was developed to improve access to the small intestine. This study evaluated the usefulness of this method for the resection of small-intestinal Peutz-Jeghers polyps.

Methods

Two patients with Peutz-Jeghers syndrome underwent nonsurgical double-balloon enteroscopic resection of polyps throughout the small intestine.

Observations

Multiple polyps in the jejunum were successfully resected via the oral route, as were the polyps in the ileum via the anal route. All 18 polyps (10-60 mm in size) were resected without subsequent bleeding or perforation. Histopathologically, 3 large polyps (>30 mm diameter) were hamartomas with adenomatous components.

Conclusions

Double-balloon enteroscopy was safe and useful for the diagnosis and the treatment of Peutz-Jeghers polyps throughout the small intestine. Double-balloon enteroscopic polypectomy might preclude complications of Peutz-Jeghers syndrome, including intussusception, bleeding, and tumorogenesis, thereby obviating the need for multiple laparotomies.