Small bowel obstruction in a patient with Peutz-Jeghers syndrome: the role of intraoperative endoscopy

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

“…When enterotomy is necessary, the transenteric route has the advantage that the scope can be guided by the surgeon, so that the entire bowel can easily be examined proximally and distally [5,15]. Bulky lesions and thick-stalked polyps unsuitable for snare polypectomy need enterotomy for an open polypectomy to be performed.…”

“…Resectioning is performed only in the presence of local concentration, invaginated unreduced intussusception, or serosal retrition with polyps. Some operators have chosen the oral route [5,10,18], whereas others have chosen the enterotomy incision [7,15]. Both routes were applied in studies by Spigment [14] and Mathus-Vliegen [9].…”

“…The endoscope used can be a gastroscope [14,15], a jejunscope [9], or a colonscope (pediatric or adult) [5,9,10,14,16]. The coloscope's length and diameter is adequate for doing a polypectomy.…”

Intraoperative enteroscopy detects more lesions but is not predictive of postoperative recurrence in Crohn’s disease

“…Whereas IOE has been suggested as a useful procedure for patients with occult intestinal bleeding [14] or Peutz-Jeghers syndrome [18] the necessity of the procedure remains inconclusive for patients with CD. [9,17].…”

“…Minute mucosal lesions can be detected Correspondence to: M. Esaki by double-contrast radiography of the small intestine [11], but preoperative radiography in patients who require surgery occasionally is inadequate for precise evaluation because of poor conditions. Intraoperative enteroscopy (IOE) has been applied for various intestinal diseases [14,18], but the clinical value of the procedure in CD has been investigated in only a limited number of articles [9,17]. Lescut el al.…”