Korean J Gastrointest Endosc > Volume 39(6); 2009 > Article
Korean Journal of Gastrointestinal Endoscopy 2009;39(6): 338-345.
이중 풍선 소장 내시경을 이용한 Peutz-Jeghers 증후군의 소장 폴립 절제술
울산대학교 의과대학 서울아산병원 내과학교실
Endoscopic Polypectomy of Small Intestinal Peutz-Jeghers Polyps with Double Balloon Enteroscopy
Mi-Young Kim, M.D., Jeong-Sik Byeon, M.D., Kee Don Choi, M.D., Byong Duk Ye, M.D., Dong-Hoon Yang, M.D., Soon Man Yoon, M.D., Kyung-Jo Kim, M.D., Seung-Jae Myung, M.D., Suk-Kyun Yang, M.D. and Jin-Ho Kim, M.D.
Department of Internal Medicine, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea

Small intestinal polyps in patients with Peutz-Jeghers (PJ) syndrome cause therapeutic difficulties because of the necessity for repeated laparotomy. We evaluated the short-term outcomes and long-term usefulness of double balloon enteroscopy (DBE) polypectomy for treating small intestinal PJ polyps.
We retrospectively reviewed 10 patients with PJ syndrome (M:F=7:3, mean age 22.7 years) and whose small intestinal polyps were resected with DBE between January 2005 and July 2008. We analyzed their clinical, endoscopic and pathologic features, the short-term outcomes and the long-term follow-up results.
Among 10 patients, 2 complained hematochezia and 2 presented with intussusceptions. DBE polypectomy was performed by the oral route in 4 patients, by the anal route in 1 and by both routes in 5 without significant complications, except for only one perforation. The polyps were 0.5∼6 cm in size and most of them were pedunculated. The histopathology revealed hamartomatous polyps in most cases. Follow-up small bowel series was performed in 6 of 10 patients, and 3 showed remnant polyps. Two of them underwent repeated DBE polypectomy without significant complications.
We suggest that DBE polypectomy is a useful treatment for PJ small intestinal polyps because of the good short-term outcome and the effectiveness of repeated polypectomy for the remnant or recurrent polyps. (Korean J Gastrointest Endosc 2009;39:338-345)
Key Words: Peutz-Jeghers syndrome, Double balloon enteroscopy, Small intestine, Polypectomy
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