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
김미영ㆍ변정식ㆍ최기돈ㆍ예병덕ㆍ양동훈ㆍ윤순만ㆍ김경조ㆍ명승재ㆍ양석균ㆍ김진호
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
Abstract

Background/Aims:
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.
Methods:
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.
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.
Conclusions:
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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