Combined endoscopic and surgical treatment for the polyposis of Peutz-Jeghers syndrome

Repeated laparotomy with extensive small bowel resectioning and eventual sh ort-bowel syndrome is a major problem in Peutz-Jeghers syndrome (PJS) patie nts. This problem is caused by gastrointestinal. polyposis with intussuscep tion. A combined surgical and endoscopic approach can assess the extent of the polyposis, and small polyps can be removed by snare polypectomy. This c an avert multiple enterotomies and decrease bowel resection segments. We ap plied an intraoperative colonscope via the enterotomy route in an 20-year-o ld PJS woman, and successfully removed the other 10 polyps distributed in t he whole small bowel. As part of an aggressive approach to the management o f polyposis in PJS, complete polypectomy can provide a longer symptom-free interval and remove potentially premaligment polyps.