A Case Report Of Peutz-jeghers Syndrome And Literature Review

Objective: To explore the epidemiology,clinical features,imaging examination,differential diagnosis,treatment,follow-up visit Peutz-Jeghers syndrome(PJS),standardize treatment methods and follow-up plans,and improve the early diagnosis and treatment rate,treatment level and follow-up awareness of PJS.To reduce the incidence of cancer in the digestive tract polyps,prolong the survival of patients and improve the quality of life of patients later.Methods: Analyze a patient’s experience in diagnosis and treatment of PJS patients,review and summarize the relevant literature.Data:Young female patients,intermittent abdominal pain more than a month,ingers and cheeks scattered spots,not above the mucosa.Asked history five years ago,particular hospital lips line "laser speckle technique",no relevant family history.Inerventions: Various routine examinations such as chest and abdomen CT,electronic gastroscope,electronic colonoscopy,biopsy pathology and pathological consultation in external hospitals to confirm the diagnosis,while giving treatments such as fasting water,anti-inflammatory,acid suppression,fluid replacement,nutritional support and symptomatic treatment,combined After comprehensive analysis of the results,it was decided to perform endoscopic gastroduodenal,colonic and rectal polypectomy for intussusception and small intestine multiple tumor resection.Postoperative antiinflammatory,acid-suppressing,rehydration and nutritional support were given.And other symptomatic treatment,early postoperative activities of paralyzed patients,to avoid the occurrence of intestinal adhesions,to create a favorable "environment" for the patient’s possible repeated surgery in the later stage,close follow-up after discharge.Results: Thoracic and abdominal CT: ascending,transverse colon wall thickening with nesting,it is recommended to further examination;left upper abdomen small intestine multiple nodular enhancement imaging,suggest further examination;uterine effusion;pelvic effusion;no abnormal signs in both lungs.Pathology of colonoscopy biopsy in the external hospital showed: A: inflammatory hyperplastic polypoid tissue with epithelial mild dysplasia,recommended for review after treatment;B,C tubular adenoma.Gastroscope showed: gastroduodenal polyps.Biopsy pathology showed: adenomatous polyps.Endoscopic colon polypectomy showed: ascending colon: inflammatory polyps with mild dysplasia of the gland;descending colon: serrated adenoma with low grade intraepithelial neoplasia.Postoperative pathology showed: ileal end mass,distal jejunal mass,small intestine mass: PeytzJeghers polyp.Conclusion: Peutz-Jeghers syndrome(PJS)often treats with acute abdomen.For example,intussusception in this case is often accompanied by abdominal pain and vomiting.Some patients have no related family genetic history,but often manifest as multiple gastrointestinal hamartoma-like polyps and skin mucosal pigmentation spots.Combined with physical examination,detailed medical history,electronic gastrointestinal endoscopy and pathology,the comprehensive diagnosis can improve the accuracy of diagnosis.At present,the disease cannot be cured.The key to treating this disease is to maintain the gastrointestinal tract polyps.Electronic endoscopy and treatment focus on the examination of other systems based on the principle of "ruling".