title: Management of duodenal-jejunal polyps in children with peutz-jeghers syndrome with single-balloon enteroscopy.
abstract: OBJECTIVE
  Children with Peutz-Jeghers syndrome (PJS) have increased risk of polyp-related complications and emergency laparotomies. The aim of the present study was to assess the efficacy and the safety of endoscopic therapy of small bowel polyps using single-balloon enteroscopy (SBE) in children affected by PJS.
  
  
  METHODS
  Between January 2010 and December 2011, prospectively consecutive PJS children with polyps >15 mm or polyps actively bleeding previously identified using video capsule endoscopy and magnetic resonance imaging underwent therapeutic SBE. The main outcome measurements were the feasibility, the technical performance, and the safety.
  
  
  RESULTS
  A total of 10 children (6 boys; median age 13.7 years, range 5.6-15.6) underwent 23 SBE procedures. Four patients had a history of abdominal surgery. A total of 53 polyps were removed, and 23 of them were >15 mm. The majority of polyps were found in jejunum (85%). The mean insertion depths for antegrade and retrograde approach were 200 ± 80 and 100 ± 50 cm beyond the ileal valve, respectively. The mean procedure time was 75 ± 25 minutes. Mild abdominal pain was reported after 3 procedures. In 1 patient a postpolypectomy perforation occurred.
  
  
  CONCLUSIONS
  In conclusion, SBE is an effective endoscopic tool for treating small bowel polyps in children with PJS, and well-timed polypectomy may optimize patients' care, preventing polyp-related complications and emergency laparotomy. Further larger multicenter studies are warranted to accurately determine the safety of therapeutic SBE in children.
authors.affiliation: *Gastroenterology and Endoscopy Service, University of Parma, Parma, Italy †Department of Gastroenterology, Great Ormond Street Hospital, London, UK.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bizzarri
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Borrelli
authors.forename: Nicola
authors.initials: N
authors.lastname: de'Angelis
authors.forename: Alessia
authors.initials: A
authors.lastname: Ghiselli
authors.forename: Giorgio
authors.initials: G
authors.lastname: Nervi
authors.forename: Marco
authors.initials: M
authors.lastname: Manfredi
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: de'Angelis
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000601:surgery*; D007416:Intestinal Perforation / Q000209:etiology*; D007417:Intestinal Polyps / Q000601:surgery*; D007579:Jejunal Diseases / Q000601:surgery*; D008297:Male; D061646:Operative Time; D010580:Peutz-Jeghers Syndrome / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome