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KMID : 0359020090390060338
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Korean Journal of Gastrointestinal Endoscopy
2009 Volume.39 No. 6 p.338 ~ p.345
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Endoscopic Polypectomy of Small Intestinal Peutz-Jeghers Polyps with Double Balloon Enteroscopy
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Kim Mi-Young
Byeon Jeong-Sik
Choi Kee-Don
Ye Byong-Duk
Yang Dong-Hoon
Yoon Soon-Man
Kim Kyung-Jo
Myung Seung-Jae
Yang Suk-Kyun
Kim Jin-Ho
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Abstract
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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.
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KEYWORD
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Peutz-Jeghers syndrome, Double balloon enteroscopy, Small intestine, Polypectomy
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