Contribution of capsule endoscopy to Peutz-Jeghers syndrome management in children

Dig Liver Dis. 2012 Oct;44(10):839-43. doi: 10.1016/j.dld.2012.05.018. Epub 2012 Jul 12.

Abstract

Background: Capsule endoscopy is recommended for children with Peutz-Jeghers syndrome as young as 8 years of age. Aim of our study was to evaluate the contribution of capsule endoscopy in managing risk of further obstructive complications.

Methods: A retrospective analysis of 27 children who received at least 1 capsule endoscopy was conducted. Peutz-Jeghers syndrome was diagnosed based on the presence of an STK11 gene mutation or on the association of a hamartoma with 2 of 3 criteria (family history, mucocutaneous pigmentation, small bowel polyposis).

Results: Thirty-seven capsule endoscopies were performed in 27 patients. The median age at first endoscopy was 11.4 years (range, 5.4-20.9). Jejunal polyps were found in 72% and ileal polyps in 55% of capsules. The original recommendations were followed 20/30 times. Three gastroscopies, 4 colonoscopies, 7 double balloon enteroscopies and 1 intra-operative enteroscopy were performed after the capsules. These procedures revealed jejunal polyps in 9/9 cases (8/9 resected) and ileal polyps in 3/5 (all resected). One intussusception occurred 8.4 months after the capsule endoscopy and required surgical resection.

Conclusion: Capsule endoscopy is easily feasible in Peutz Jeghers syndrome, but the practice of systematic and repeated procedures needs to be validated prospectively.

MeSH terms

  • Adolescent
  • Capsule Endoscopy*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Intestinal Polyps / complications
  • Intestinal Polyps / diagnosis*
  • Intestine, Small / pathology*
  • Intussusception / etiology
  • Male
  • Peutz-Jeghers Syndrome / diagnosis*
  • Retrospective Studies
  • Young Adult