F Mandraka1, C Zuelke, G Lock. 1. Klinik und Poliklinik für Innere Medizin I, Klinikum der Universität Regensburg. falitsa.mandraka@medicdat.de
Abstract
HISTORY AND CLINICAL FINDINGS: A 54-year-old patient with painless jaundice and vomiting had been diagnosed with a Peutz-Jeghers syndrome 20 years before. INVESTIGATIONS: The blood analysis showed a cholestatic constellation as well as increased transaminases. Sonographic, radiological, endoscopic and histological findings indicated multiple hamartomatous polyps of the Peutz-Jeghers' type in the entire small and large bowel with occlusion of the papilla of Vater and the superior gastrointestinal tract by a big polyp. TREATMENT AND COURSE: After an initial percutaneous transhepatic cholangiographic drainage, Whipple's operation and a segmental resection of small and large bowel were performed. A highly differentiated adenocarcinoma of the duodenum was found in the resected specimen. CONCLUSION: This case demonstrates the potentially severe complications of a Peutz-Jeghers syndrome that had been neglected for years.
HISTORY AND CLINICAL FINDINGS: A 54-year-old patient with painless jaundice and vomiting had been diagnosed with a Peutz-Jeghers syndrome 20 years before. INVESTIGATIONS: The blood analysis showed a cholestatic constellation as well as increased transaminases. Sonographic, radiological, endoscopic and histological findings indicated multiple hamartomatous polyps of the Peutz-Jeghers' type in the entire small and large bowel with occlusion of the papilla of Vater and the superior gastrointestinal tract by a big polyp. TREATMENT AND COURSE: After an initial percutaneous transhepatic cholangiographic drainage, Whipple's operation and a segmental resection of small and large bowel were performed. A highly differentiated adenocarcinoma of the duodenum was found in the resected specimen. CONCLUSION: This case demonstrates the potentially severe complications of a Peutz-Jeghers syndrome that had been neglected for years.