No abstract

We present a case of a 37-year-old woman who presented with acute right lower quadrant abdominal pain. Work up with contrast enhanced CT to rule out appendicitis revealed dramatic ring enhancing cystic structure in the right adnexa corresponding to tubal ring sign of ectopic pregnancy seen on subsequent pelvic ultrasound. Right tubal ectopic pregnancy was confirmed at surgery.

Peutz-Jeghers syndrome (PJS) is an autosomal dominant inheritance characterized by intestinal hamartomatous polyps and hyperpigmented mucocutaneous macules. Bleeding, bowel obstruction, and intussusception are the most common complications in PJS patients. Individuals are infrequently present for the first time with bowel obstruction secondary to intussusception. Intestinal intussusception presentation is often observed clearly on multidetector computed tomography (MDCT) with characteristic findings, such as "target" and "pseudo-kidney" signs, and sometimes shows the cause of lead-point polyp. A complemental examination is needed to attain more diagnostic symptoms of this disorder, including pigmented spots on the oral cavity and lips, family history with multiple gastrointestinal polyps. Here, we report a case of a 17year-old male who showed traits of Peutz-Jeghers syndrome. However, the diagnosis was not made until he later developed bowel obstruction caused by an ileo-ileal intussusception manifestation on MDCT and eventually proved in typical hamartoma on postoperative histopathology.