Peutz-Jeghers综合征合并巨大结肠息肉应用STER治疗1例

A Case of Peutz-Jeghers Syndrome Combined with Giant Colonic Polyps Treated with STER

摘要: 患者男性，17岁，因“偶有腹痛9年”就诊。体格检查发现：口唇、口腔黏膜、手掌、脚掌可见散在点状黑斑，1~3 mm，边界清晰，压之不褪色；下腹部可见长约15 cm陈旧性手术瘢痕，无压痛及反跳痛，以“Peutz-Jeghers综合征”收住入院。入院后完善电子胃肠镜，见巨大结肠息肉，经综合评估后行经黏膜下隧道结肠病损切除术(Submucosal Tunneling Endoscopic Resection, STER)治疗，术后病理示Peutz-Jeghers息肉。Peutz-Jeghers (Peutz-Jeghers syndrome, PJS)综合征易发生消化道错构瘤性息肉，切除胃肠道息肉是治疗的关键，治疗方法包括内镜治疗和外科手术治疗。随着内镜技术的成熟，对于无严重并发症的胃肠道息肉，首选的治疗方法是内镜下息肉切除。通过对该病例的介绍，进一步提高对PJS综合征的认识，为同类患者的内镜下治疗提供参考。

Abstract: The patient was a 17-year-old male who presented to the clinic with “occasional abdominal pain for 9 years”. Physical examination revealed scattered dotted black spots, 1~3 mm in length, with clear borders and no discoloration under pressure, on the lips, oral mucosa, palms and feet; old surgical scar of about 15 cm in length, without pressure or rebound pain, on the lower abdomen. He was admitted to the hospital with Peutz-Jeghers syndrome. After hospital admission, electronic gastros-copy was completed and a huge colonic polyp was seen. After comprehensive evaluation, STER was performed and postoperative pathology showed a Peutz-Jeghers polyp. Peutz-Jeghers syndrome is prone to misshapen polyps of the gastrointestinal tract, and resection of gastrointestinal polyps is the key to treatment, which includes endoscopic treatment and surgical treatment. With the matu-ration of endoscopic techniques, the preferred treatment for gastrointestinal polyps without serious complications is endoscopic polypectomy. The case is presented to further improve the under-standing of Peutz-Jeghers syndrome and to provide a reference for the endoscopic treatment of sim-ilar patients.