Intraoperative small bowel enteroscopy in familial adenomatous and familial juvenile polyposis.
BACKGROUND
In familial adenomatous polyposis and juvenile polyposis, polyps can occur throughout the gastrointestinal tract.


METHODS
We report seven patients with familial adenomatous polyposis and two patients with juvenile polyposis who underwent small bowel enteroscopy at the time of exploratory celiotomy either for colectomy or other pathology.


RESULTS
Polyps in the jejunum and/or ileum were noted in five of nine (56%) patients at enteroscopy. In three of nine (33%) patients these polys were adenomatous. Two of these patients had polyps in the jejunum and in the ileum, whereas one patient had jejunal adenomas alone. These polyps were from 3 mm to 30 mm in size. The remaining two patients with polyps had lymphoid hyperplasia in the ileum. All three patients who had adenomas at intraoperative small bowel enteroscopy had duodenal adenomas at esophagogastroduodenoscopy. At the age of 14 years, one patient had an intramucosal carcinoma in a small bowel juvenile polyp.


CONCLUSIONS
Baseline small bowel enteroscopy should be considered at the time of surgical exploration in patients with asymptomatic familial adenomatous polyposis and juvenile polyposis. In patients with duodenal polyps, enteroscopy should be performed at the time of surgery. Biopsy and/or excision of larger polyps should be performed because these polyps may harbor a carcinoma.
Rodriguez-Bigas
M A
MA
Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, New York, USA.
Penetrante
R B
RB
Herrera
L
L
Petrelli
N J
NJ
D011125:Adenomatous Polyposis Coli / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D002648:Child; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D007078:Ileal Neoplasms / Q000473:pathology*; D007417:Intestinal Polyps / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D007432:Intraoperative Period; D007580:Jejunal Neoplasms / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies