Bhattacharya, Sayantan, Mahapatra, Sunondo R., Nangalia, Ramlal, Palit, Amitabh, Morrissey, John R., Ruban, Ernie, Jadhav, Vijay and Mathew, G. (George). (2010) Melaena with Peutz-Jeghers syndrome: a case report. Journal of Medical Case Reports, Vol.4 (Article 44). ISSN 1752-1947

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Abstract

Introduction: Peutz-Jeghers syndrome (PJS) is a rare familial disorder characterised by mucocutaneous pigmentation, gastrointestinal and extragastrointestinal hamartomatous polyps and an increased risk of malignancy. Peutz-Jeghers polyps in the bowel may result in intussusception. This complication usually manifests with abdominal pain and signs of intestinal obstruction. Case Presentation: We report the case of a 24-year-old Caucasian male who presented with melaena. Pigmentation of the buccal mucosa was noted but he was pain-free and examination of the abdomen was unremarkable. Upper gastrointestinal endoscopy revealed multiple polyps. An urgent abdominal computed tomography (CT) scan revealed multiple small bowel intussusceptions. Laparotomy was undertaken on our patient, reducing the intussusceptions and removing the polyps by enterotomies. Bowel resection was not needed. Conclusion: Melaena in PJS needs to be urgently investigated through a CT scan even in the absence of abdominal pain and when clinical examination of the abdomen shows normal findings. Although rare, the underlying cause could be intussusception, which if missed could result in grave consequences.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Institute of Clinical Education (ICE) Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Peutz-Jeghers syndrome -- Case studies, Melaena -- Case studies, Intestines -- Diseases -- Diagnosis, Intestines -- Intussusception
Journal or Publication Title:	Journal of Medical Case Reports
Publisher:	BioMed Central Ltd.
ISSN:	1752-1947
Date:	8 February 2010
Volume:	Vol.4
Number:	Article 44
Identification Number:	10.1186/1752-1947-4-44
Status:	Peer Reviewed
Access rights to Published version:	Open Access
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URI:	http://wrap.warwick.ac.uk/id/eprint/3017

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