Contribution of capsule endoscopy to Peutz-Jeghers syndrome management in children.
BACKGROUND
Capsule endoscopy is recommended for children with Peutz-Jeghers syndrome as young as 8 years of age. Aim of our study was to evaluate the contribution of capsule endoscopy in managing risk of further obstructive complications.


METHODS
A retrospective analysis of 27 children who received at least 1 capsule endoscopy was conducted. Peutz-Jeghers syndrome was diagnosed based on the presence of an STK11 gene mutation or on the association of a hamartoma with 2 of 3 criteria (family history, mucocutaneous pigmentation, small bowel polyposis).


RESULTS
Thirty-seven capsule endoscopies were performed in 27 patients. The median age at first endoscopy was 11.4 years (range, 5.4-20.9). Jejunal polyps were found in 72% and ileal polyps in 55% of capsules. The original recommendations were followed 20/30 times. Three gastroscopies, 4 colonoscopies, 7 double balloon enteroscopies and 1 intra-operative enteroscopy were performed after the capsules. These procedures revealed jejunal polyps in 9/9 cases (8/9 resected) and ileal polyps in 3/5 (all resected). One intussusception occurred 8.4 months after the capsule endoscopy and required surgical resection.


CONCLUSIONS
Capsule endoscopy is easily feasible in Peutz Jeghers syndrome, but the practice of systematic and repeated procedures needs to be validated prospectively.
CHU Rennes, Department of Pediatrics, South Hospital, Rennes cedex, France.
Swellen
S
Gastineau
Jérôme
J
Viala
Dominique
D
Caldari
Emmanuel
E
Mas
Estelle
E
Darviot
Catherine
C
Le Gall
Chantal
C
Maurage
Laurent
L
Michaud
Alain
A
Dabadie
D000293:Adolescent; D053704:Capsule Endoscopy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007417:Intestinal Polyps / Q000150:complications / Q000175:diagnosis*; D007421:Intestine, Small / Q000473:pathology*; D007443:Intussusception / Q000209:etiology; D008297:Male; D010580:Peutz-Jeghers Syndrome / Q000175:diagnosis*; D012189:Retrospective Studies; D055815:Young Adult