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一名儿科患者出现空肠回肠套叠的黑斑息肉综合征:埃塞俄比亚贡德尔一个发展中国家的罕见病例报告

Peutz-Jeghers syndrome presenting with jejunoileal intussusception in a pediatric patient: A rare case report, in a developing country, Gondar, Ethiopia.

作者信息

Yigzaw Kinfemicheal Tilahu, Mulualem Dawit Aysheshim, Asefa Hailemariam Yohannes, Wassie Mesfin Tesera, Shiferaw Ephrem Awoke, Gebrehiwet Cheru Lilay

机构信息

Department of Internal Medicine, College of Medicine and Health Sciences, Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.

Department of Surgery, College of Medicine and Health Sciences, Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.

出版信息

Int J Surg Case Rep. 2025 Sep;134:111715. doi: 10.1016/j.ijscr.2025.111715. Epub 2025 Jul 30.

Abstract

INTRODUCTION

Peutz-Jeghers Syndrome (PJS) is a rare genetic disorder characterized by the presence of hamartomatous polyps and distinctive mucocutaneous pigmentation, caused by mutations in the STK11 gene. This case report highlights a pediatric patient presenting with jejunoileal intussusception associated with PJS in Gondar, Ethiopia.

CASE PRESENTATION

An 8-year-old female presented with persistent abdominal pain, bilious vomiting, and inability to pass stools for two days, alongside lip pigmentation noted since birth. Upon examination, she exhibited signs of dehydration and abdominal distension, with ultrasound indicating intestinal obstruction due to intussusception. Emergency laparotomy revealed an 18 cm jejunoileal intussusception with three associated polyps. The gangrenous segment of the intestine was resected, and an end-to-end anastomosis was performed.

DISCUSSION

PJS is typically diagnosed based on the presence of polyps and mucocutaneous pigmentation. Our patient met the diagnostic criteria with three hamartomatous polyps and characteristic lip pigmentation. The prevalence of PJS is about 1 in 100,000, and the condition may lead to significant complications, including intussusception, particularly in children. Following surgery, the patient's recovery was uneventful, underscoring the importance of early diagnosis and intervention.

CONCLUSION

This case highlights the importance of recognizing PJS in pediatric populations, particularly in the context of gastrointestinal symptoms, to prevent severe complications, such as intussusception, and ensure prompt management.

摘要

引言

黑斑息肉综合征(PJS)是一种罕见的遗传性疾病,其特征为存在错构瘤性息肉和独特的黏膜皮肤色素沉着,由STK11基因突变引起。本病例报告重点介绍了一名来自埃塞俄比亚贡德尔的儿科患者,该患者患有与PJS相关的空肠回肠套叠。

病例介绍

一名8岁女性因持续腹痛、胆汁性呕吐且两天未解大便前来就诊,自出生起即有唇部色素沉着。检查时,她出现脱水和腹胀迹象,超声显示因套叠导致肠梗阻。急诊剖腹探查发现一段18厘米的空肠回肠套叠,伴有三个相关息肉。切除坏死肠段并进行端端吻合术。

讨论

PJS通常根据息肉和黏膜皮肤色素沉着的存在来诊断。我们的患者有三个错构瘤性息肉和典型的唇部色素沉着,符合诊断标准。PJS的患病率约为十万分之一,该疾病可能导致严重并发症,包括套叠,尤其是在儿童中。手术后,患者恢复顺利,凸显了早期诊断和干预的重要性。

结论

本病例强调了在儿科人群中识别PJS的重要性,特别是在出现胃肠道症状的情况下,以预防诸如套叠等严重并发症,并确保及时治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2643/12345879/98243357eb5b/gr1.jpg

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