We present a case of a 24-year-old woman with Peutz-Jeghers syndrome, recurrent colic abdominal pain, and lower gastrointestinal bleed for the last 5 years. Colonoscopy showed hamartomas without any dysplasia. In the enteral magnetic resonance imaging, a distal jejunum and ileum invagination, secondary to hamartomas was detected. The patient was referred to the Surgery Department and despite few symptoms, elective surgery was proposed. By laparoscopic surgery approach, the entire bowel was carefully revised, 3 intussusceptions and bowel volvulus were found, 2 in jejunum and 1 in ileum, causing incomplete obstruction and intestinal dilatation, with a diameter of 6 cm. These intussusception areas were marked with a silk filament, after achieving devolvulation and disinvagination. A 5-cm laparotomy was done, to externalize the entire bowel, to explore it manually, to verify the absence of other lesions, and locate silk points. By longitudinal enterotomies on the antimesenteric intestinal border where silk filaments were located, the polyps were removed through their stalk, and the enterotomies were transversely closed. Postoperative evolution was favorable, starting oral tolerance on the fourth day and being discharged from the hospital on the seventh day. Eight months later, the patient was asymptomatic with a better quality of life.
Case Rep Gastroenterol 2021;15:495–500

中文翻译：

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微创择期手术治疗 Peutz-Jeghers 综合征病例肠内陷

我们介绍了一例 24 岁女性，在过去 5 年中患有 Peutz-Jeghers 综合征、复发性绞痛腹痛和下消化道出血。结肠镜检查显示错构瘤，没有任何发育不良。在肠内磁共振成像中，检测到继发于错构瘤的远端空肠和回肠内陷。患者被转诊至外科，尽管症状很少，但仍建议择期手术。经腹腔镜手术入路，仔细翻修整个肠道，发现肠套叠和肠扭转3处，空肠2处，回肠1处，造成不完全梗阻和肠道扩张，直径6 cm。这些肠套叠区域在实现解卷和去内陷后用丝线标记。进行了 5 厘米的剖腹手术，将整个肠道外化，手动探索，确认没有其他病变，并定位丝点。通过在丝丝所在的肠系膜肠缘进行纵向切开术，通过其柄去除息肉，并横向关闭切开术。术后进展良好，第4天开始口服耐受，第7天出院。八个月后，患者无症状，生活质量有所改善。第四天开始口服耐受，第七天出院。八个月后，患者无症状，生活质量有所改善。第四天开始口服耐受，第七天出院。八个月后，患者无症状，生活质量有所改善。
Case Rep Gastroenterol 2021；15:495–500