What is the role of endoscopy in the workup of Peutz-Jeghers syndrome (PJS)?

Updated: Oct 11, 2018
  • Author: Buu Anh T To, MD; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Symptoms such as abdominal pain or anemia/melena require investigation with upper and lower endoscopy. Traditionally, primary surgical resection and IOE were the only available options for treating polyps in the mid small bowel in patients with Peutz-Jeghers syndrome [87, 88, 89, 90] ; this strategy did not allow for a preventive approach to recurrent small intestinal obstruction. WCE may improve the likelihood of detection of small intestinal polyps [91] ; however, definitive management may, given the availability of suitable expertise, depend on advanced enteroscopic techniques, including push-enteroscopy, spiral enteroscopy, and double-balloon enteroscopy with polypectomy. [92]

In a 2017 report, Belsha et al demonstrated in a small number of cases that DBE-faciliated polypectomy is an effetive therapeutic option with minimal complications. [93]

Small intestinal polyps may be removed as part of a “clean-sweep” strategy for disease surveillance or because they are resulting in symptoms, including bleeding.

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