Endoscopy 2018; 50(04): S149-S150
DOI: 10.1055/s-0038-1637483
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

SUCCESS AND FAILURES OF DOUBLE-BALLOON ENTEROSCOPY IN DIAGNOSTIC AND TREATMENT OF PEUTZ-JEGHERS SYNDROME

A Varabei
1   Belarusian Medical Academy of Postgraduate Education, Surgery, Minsk, Belarus
,
A Makhmudov
1   Belarusian Medical Academy of Postgraduate Education, Surgery, Minsk, Belarus
,
A Subach
2   N.N.Alexandrov National Cancer Centre of Belarus, Genetics, Minsk, Belarus
,
T Chakhovich
2   N.N.Alexandrov National Cancer Centre of Belarus, Genetics, Minsk, Belarus
,
N Lahodzich
1   Belarusian Medical Academy of Postgraduate Education, Surgery, Minsk, Belarus
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

Also available ateRef
 

Aims:

To evaluate possibilities of double-balloon enteroscopy (DBE) in patients who have undergone operations for enteric intussusception.

Methods:

From 2009 to 2017 in our center DBE were performed at 12 patients after conservative resolving enteric intussusception. Peutz-Jeghers polyps (PJP) are revealed in 6 (50%) patients. There were 3 women and 3 men. Average age is 32,4 ± 14,05 (18 – 52 years). Earlier 5 (83%) patients were operated because of acute intussusceptions and 4 (66,7%) from them – twice.

Results:

The histological examination of resected polyps has revealed features of PJP. STK11 mutations are detected in 2 (33%) patients with family history of Peutz-Jeghers Syndrome (PJS). Mucocutaneous pigmentations were found in all 6 patients.

The intussusception was diagnosed during DBE in 1 patient. It was resolved successfully with two balloons and gamartoma was removed by endoscopic polypectomy.

The total enteroscopy with polypectomy have carried out in 2 (33%) patients. All 37 polyps (size 10 – 60 mm) were resected.

The total enteroscopy have not performed in 3 patients because of adhesions and in 1 patient because of existence of malignant transformation PJP. Laparotomy with intraoperative enteroscopy and polypectomy were carried out in 2 patients. DBE with polypectomy under laparoscopic control and partial resection of the small intestine were performed in 2 patients. All 89 resected polyps were more than 10 mm. One case of polypectomy was complicated of bleeding which was stopped by injection therapy at bleeding site.

Controled DBE were performed for 3 patients in 1 and in 3 years. In that cases growth of polyps weren't revealed. In 5 years DBE revealed in 1 patient 3 PJP (20 mm) which were removed during procedure.

Conclusions:

DBE with polypectomy is useful and safe for diagnosis and preventive for intussusception in patients with PJS. However, her opportunities are limited in patients with multiple laparotomies. Such cases sometimes demand intraoperative enteroscopy.