title: Laparoscopic treatment of intestinal intussusception in Peutz-Jeghers syndrome: case report and review of literature.
abstract: A 47-year-old woman presented with an abdominal mass and nausea. Abdominal ultrasound and computed tomography (CT) showed a sausage-shaped mass with invagination. One polyp that appeared to exceed 3 cm was found in the sigmoid colon. Laparoscopy confirmed an intussusception mass, and the intussusception was dissected by hand-assisted laparoscopy (HALS). The sigmoid colon was also mobilized to the site of the small incision and resected. Generally, we believe enterectomy including polyps should be avoided as much as possible in Peutz-Jeghers syndrome (PJS) because poly-surgery may lead to short bowel syndrome. In addition, PJS patients often undergo multiple surgery, and therefore dense intra-abdominal adhesions are seen at subsequent laparotomy, which makes surgery increasingly difficult with repeated operations. Laparoscopic-assisted surgery seems beneficial, as in the present case.
authors.affiliation: Department of Surgery, Tokai University Hachioji Hospital, 1838 Ishikawacho, Hachioji, Tokyo 192-0032, Japan. sayuri-m@muc.biglobe.ne.jp
authors.forename: Sayuri
authors.initials: S
authors.lastname: Hasegawa
authors.forename: Takafumi
authors.initials: T
authors.lastname: Sekka
authors.forename: Jinichi
authors.initials: J
authors.lastname: Soeda
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ishizu
authors.forename: Eisuke
authors.initials: E
authors.lastname: Ito
authors.forename: Seiji
authors.initials: S
authors.lastname: Morita
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Makuuchi
mesh_terms: D003113:Colonoscopy; D005260:Female; D058733:Hand-Assisted Laparoscopy / Q000379:methods*; D006801:Humans; D007443:Intussusception / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D010580:Peutz-Jeghers Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography