Larger intestinal intussusception reported in a patient with Peutz-Jeghers syndrome. Case report.

Abstract

 Intestinal intussusception is considered a rare cause of intestinal obstruction in adults, its effects are severe and often require surgical intervention, given its non-specific clinical manifestations makes its diagnosis a challenge for the surgeon. Peutz-Jeghers syndrome (PJS) is a rare genetic disease, characterized by the presence of intestinal hamartomous polyps and characteristic mucocutaneous pigmentations. During their growth, these polyps can become complicated and cause intussusception, obstruction and intestinal bleeding. We present the case of an 18-year-old female patient diagnosed with Peutz Jeghers Syndrome since she was 5 years old, who reported the onset of current illness 13 days prior to admission, characterized by moderately intense colic pain in the epigastrium, liquid stools, 5 per day, without mucus or blood. nausea and vomiting from food content on multiple occasions. Abdominal US was performed, evidencing a rounded image in the hypoechoic epigastrium measuring 78.4 mm x 49.3 mm. She was taken to the operating table under the diagnosis of acute obstructive abdomen secondary to: Intussusception. The surgical findings reported a 60cm jejunal intusuceptum with irreversible ischemic changes, so it was decided to perform resection and anastomosis, the patient evolved satisfactorily so it was decided to discharge the patient on the 8th day. Evaluating the available literature, the longest reported so far is 50cm, therefore our work aims to provide new information and academic memory about this entity.