[Cholestasis and vomiting: unusual differential diagnosis in a case of Peutz-Jeghers syndrome].
METHODS
A 54-year-old patient with painless jaundice and vomiting had been diagnosed with a Peutz-Jeghers syndrome 20 years before.


METHODS
The blood analysis showed a cholestatic constellation as well as increased transaminases. Sonographic, radiological, endoscopic and histological findings indicated multiple hamartomatous polyps of the Peutz-Jeghers' type in the entire small and large bowel with occlusion of the papilla of Vater and the superior gastrointestinal tract by a big polyp.


METHODS
After an initial percutaneous transhepatic cholangiographic drainage, Whipple's operation and a segmental resection of small and large bowel were performed. A highly differentiated adenocarcinoma of the duodenum was found in the resected specimen.


CONCLUSIONS
This case demonstrates the potentially severe complications of a Peutz-Jeghers syndrome that had been neglected for years.
Klinik und Poliklinik für Innere Medizin I, Klinikum der Universität Regensburg. falitsa.mandraka@medicdat.de
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F
Mandraka
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Zuelke
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Lock
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D002758:Cholangiography; D002779:Cholestasis / Q000209:etiology; D003937:Diagnosis, Differential; D004379:Duodenal Neoplasms / Q000175:diagnosis / Q000473:pathology; D004386:Duodenum / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D010580:Peutz-Jeghers Syndrome / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D013997:Time Factors; D014839:Vomiting / Q000209:etiology