Gastric outlet obstruction secondary to Peutz-Jeghers syndrome successfully managed by polypectomy
摘要
Peutz-Jeghers syndrome (PJS) is a genetic disorder characterized by the development of hamartomatous polyps throughout the gastrointestinal tract but primarily in the small bowel. Gastric outlet obstruction (GOO) due to PJS polyps is rare in childhood. The optimal treatment of large, gastric polyps in PJS remains unclear. We report herein the case of a 1-year-old, male patient who was treated endoscopically for GOO caused by a massive PJS polyp. The patient had a history of frequent non-bilious vomiting and melena. Gastrointestinal bleeding was suspected, prompting an abdominal ultrasound and a gastrointestinal series. The ultrasound revealed mucosal lesions in the stomach, and a contrast meal indicated a possible gastrointestinal obstruction. Endoscopy led to the diagnosis of gastric obstruction secondary to a massive PJS polyp. After carefully excluding malignancy, the polyp was excised via snare polypectomy. The present case demonstrated that gastric polyps in PJS can present with symptoms even at a young age and that abdominal ultrasound and gastrointestinal series are valuable tools for diagnosing GOO due to gastric polyps. While open surgery is typically considered for polyps causing GOO, endoscopic resection can be a safe and effective alternative.