Skip Navigation LinksHome > July 2014 - Volume 59 - Issue 1 > Management of Duodenal–Jejunal Polyps in Children With Peutz...
Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0000000000000351
Original Articles: Gastroenterology

Management of Duodenal–Jejunal Polyps in Children With Peutz-Jeghers Syndrome With Single-Balloon Enteroscopy

Bizzarri, Barbara*; Borrelli, Osvaldo; de’Angelis, Nicola*; Ghiselli, Alessia*; Nervi, Giorgio*; Manfredi, Marco*; de’Angelis, Gian Luigi*

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Abstract

Objectives: Children with Peutz-Jeghers syndrome (PJS) have increased risk of polyp-related complications and emergency laparotomies. The aim of the present study was to assess the efficacy and the safety of endoscopic therapy of small bowel polyps using single-balloon enteroscopy (SBE) in children affected by PJS.

Methods: Between January 2010 and December 2011, prospectively consecutive PJS children with polyps >15 mm or polyps actively bleeding previously identified using video capsule endoscopy and magnetic resonance imaging underwent therapeutic SBE. The main outcome measurements were the feasibility, the technical performance, and the safety.

Results: A total of 10 children (6 boys; median age 13.7 years, range 5.6–15.6) underwent 23 SBE procedures. Four patients had a history of abdominal surgery. A total of 53 polyps were removed, and 23 of them were >15 mm. The majority of polyps were found in jejunum (85%). The mean insertion depths for antegrade and retrograde approach were 200 ± 80 and 100 ± 50 cm beyond the ileal valve, respectively. The mean procedure time was 75 ± 25 minutes. Mild abdominal pain was reported after 3 procedures. In 1 patient a postpolypectomy perforation occurred.

Conclusions: In conclusion, SBE is an effective endoscopic tool for treating small bowel polyps in children with PJS, and well-timed polypectomy may optimize patients’ care, preventing polyp-related complications and emergency laparotomy. Further larger multicenter studies are warranted to accurately determine the safety of therapeutic SBE in children.

© 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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