A case of double balloon endoscopic treatment of polyps of Peutz-Jeghers syndrome by ligations and follow-up by capsule endoscopy

康太郎, 馬來; 啓吾, 三井; 祐希江, 山田; 陽子, 高橋; 彰仁, 江原; 剛, 小林; 継彦, 瀬尾; 真興, 米澤; 喜明, 柴田; 周, 田中; 篤志, 辰口; 俊二, 藤森; 長逸, 坂本

doi:10.11641/pde.75.2_88

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“…Acute pancreatitis and post-polypectomy syndrome have been reported as complications [21, 22, 48, 50]. Deep within the small intestine, it is inevitably difficult to maneuver BAE to apply a snare to the stalk of the polyp, and ischemic polypectomy using a detachable snare or clip has been described [53, 54]. It has been reported that ischemic polypectomy can treat many polyps in a shorter period than endoscopic resection, and it is less likely to cause complications [18].…”

Section: Cqs and Recommendationsmentioning

confidence: 99%

Clinical Guidelines for Diagnosis and Management of Peutz-Jeghers Syndrome in Children and Adults

et al. 2023

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Background: Peutz-Jeghers syndrome (PJS) is a rare disease characterized by the presence of hamartomatous polyposis throughout the gastrointestinal tract, except for the esophagus, along with characteristic mucocutaneous pigmentation. It is caused by germline pathogenic variants of the STK11 gene, which exhibit an autosomal dominant mode of inheritance. Some patients with PJS develop gastrointestinal lesions in childhood and require continuous medical care until adulthood and sometimes have serious complications that significantly reduce their quality of life. Hamartomatous polyps in the small bowel may cause bleeding, intestinal obstruction, and intussusception. Novel diagnostic and therapeutic endoscopic procedures such as small-bowel capsule endoscopy and balloon-assisted enteroscopy have been developed in recent years. Summary: Under these circumstances, there is growing concern about the management of PJS in Japan, and there are no practice guidelines available. To address this situation, the guideline committee was organized by the Research Group on Rare and Intractable Diseases granted by the Ministry of Health, Labour and Welfare with specialists from multiple academic societies. The present clinical guidelines explain the principles in the diagnosis and management of PJS together with four clinical questions and corresponding recommendations based on a careful review of the evidence and involved incorporating the concept of the Grading of Recommendations Assessment, Development and Evaluation system. Key Messages: Herein, we present the English version of the clinical practice guidelines of PJS to promote seamless implementation of accurate diagnosis and appropriate management of pediatric, adolescent, and adult patients with PJS.

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