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Juvenile polyposis syndrome affecting the stomach: a case report.

Kelly S, Dwerryhouse S, Safranek P, Hardwick R - J Med Case Rep (2008)

Bottom Line: Hamartomatous polyps can affect the entire gastrointestinal tract but usually predominate in the colon.A 51-year-old man presented with symptoms of gastric outlet obstruction and upper gastrointestinal bleeding.This case illustrates important principles in managing this condition.

View Article: PubMed Central - HTML - PubMed

Affiliation: Cambridge Oesophagogastric surgery centre, Addenbrookes hospital, Cambridge, UK. stevekelly999@btinternet.com

ABSTRACT

Introduction: Juvenile polyposis syndrome(JPS) is a rare autosomal dominant inherited condition. Hamartomatous polyps can affect the entire gastrointestinal tract but usually predominate in the colon. In this case report we present an unusual case of JPS that presented with massive gastric polyposis requiring a total gastrectomy.

Case presentation: A 51-year-old man presented with symptoms of gastric outlet obstruction and upper gastrointestinal bleeding. Gastroscopy showed massive gastric polyposis with a large antral polyp that had prolapsed through the pylorus causing gastric outlet obstruction. Initially endoscopic polypectomy was performed, but due to progressive symptoms a total gastrectomy was then performed. Histology confirmed massive gastric juvenile polyposis.

Conclusion: Massive gastric polyposis is an uncommon manifestation of juvenile polyposis syndrome. This case illustrates important principles in managing this condition.

No MeSH data available.


Related in: MedlinePlus

Intra-operative photo of stomach after mobilisation.
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Figure 2: Intra-operative photo of stomach after mobilisation.

Mentions: The patient presented with symptoms of vomiting, early satiety, weight loss and upper gastrointestinal bleeding. Serum haemoglobin measurement was 5 g/dl. Gastroscopy and barium meal examination revealed massive gastric polyposis with a prominent gastric antral polyp prolapsing through the pylorus and causing pyloric obstruction (figure 1). Attempts were made at endoscopic debulking of the gastric polyps but this had been unsuccessful. Surgery was therefore advised given the worsening symptoms of gastric outlet obstruction and repeated episodes of upper gastrointestinal bleeding. The patient underwent a vagal sparing total gastrectomy with a 50 cm Roux-en-Y jejunal reconstruction stapled end to side to the oesophagus. This was a difficult procedure as the stomach was very large (figure 2). There were no postoperative complications and he was discharged ten days post-surgery.


Juvenile polyposis syndrome affecting the stomach: a case report.

Kelly S, Dwerryhouse S, Safranek P, Hardwick R - J Med Case Rep (2008)

Intra-operative photo of stomach after mobilisation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2567337&req=5

Figure 2: Intra-operative photo of stomach after mobilisation.
Mentions: The patient presented with symptoms of vomiting, early satiety, weight loss and upper gastrointestinal bleeding. Serum haemoglobin measurement was 5 g/dl. Gastroscopy and barium meal examination revealed massive gastric polyposis with a prominent gastric antral polyp prolapsing through the pylorus and causing pyloric obstruction (figure 1). Attempts were made at endoscopic debulking of the gastric polyps but this had been unsuccessful. Surgery was therefore advised given the worsening symptoms of gastric outlet obstruction and repeated episodes of upper gastrointestinal bleeding. The patient underwent a vagal sparing total gastrectomy with a 50 cm Roux-en-Y jejunal reconstruction stapled end to side to the oesophagus. This was a difficult procedure as the stomach was very large (figure 2). There were no postoperative complications and he was discharged ten days post-surgery.

Bottom Line: Hamartomatous polyps can affect the entire gastrointestinal tract but usually predominate in the colon.A 51-year-old man presented with symptoms of gastric outlet obstruction and upper gastrointestinal bleeding.This case illustrates important principles in managing this condition.

View Article: PubMed Central - HTML - PubMed

Affiliation: Cambridge Oesophagogastric surgery centre, Addenbrookes hospital, Cambridge, UK. stevekelly999@btinternet.com

ABSTRACT

Introduction: Juvenile polyposis syndrome(JPS) is a rare autosomal dominant inherited condition. Hamartomatous polyps can affect the entire gastrointestinal tract but usually predominate in the colon. In this case report we present an unusual case of JPS that presented with massive gastric polyposis requiring a total gastrectomy.

Case presentation: A 51-year-old man presented with symptoms of gastric outlet obstruction and upper gastrointestinal bleeding. Gastroscopy showed massive gastric polyposis with a large antral polyp that had prolapsed through the pylorus causing gastric outlet obstruction. Initially endoscopic polypectomy was performed, but due to progressive symptoms a total gastrectomy was then performed. Histology confirmed massive gastric juvenile polyposis.

Conclusion: Massive gastric polyposis is an uncommon manifestation of juvenile polyposis syndrome. This case illustrates important principles in managing this condition.

No MeSH data available.


Related in: MedlinePlus