A Case of Ileocolic Intussusception in an Adult with Peutz-Jeghers Syndrome

Introductions: Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant disorder characterized by hamartomatous polyps in the gastrointestinal tract and hyperpigmentation on the lips and oral cavity. Bowel obstruction, intussusception and bleeding are common complications in PJS patients. PJS patients also have an increased risk of gastrointestinal and extra-intestinal malignancies. Case Description: A 32 years old male was brought to the emergency room due to suspected ileocolic intussusception. Ten years ago he had a history of laparotomy resection anastomosis of the bowel due to bowel polyps. Physical examination revealed multiple pigmented intraoral lesions. Abdominal examination showed mid-line laparotomy scar, distention with visible bowel movement. There was no palpable mass and no blood upon digital rectal examination. Computerized tomography of the abdomen demonstrated suspected ascending colon intussusception. Intra-operation; ileocolic intussusception was found with multiple polyps along the colon. Resection and stoma was done, with planned post-operative endoscopy via the stoma. Conclusion: The standard treatment for intussusception in PJS patients is laparotomy bowel resection to remove the polyps causing the recurrent invaginations. It has been recommended that endoscopic polyps removal should be performed to avoid multiple surgical resections, which lead to short bowel syndrome. Due to increased risk of malignancies, regular screening of PJ patients is needed.