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Intra‐operative Total Enteroscopy for the Management of Peutz‐Jegher's Syndrome

We present a case of Peutz‐Jegher's syndrome in an 18 year old female who was followed for gastrointestinal polyps for 13 years from the age of 5 years. The patient was treated four times with surgical or endoscopic polypectomy for gastrointestinal polyps. At the age of 14 years, a combined surgical and endoscopic approach for the management of Peutz‐Jegher's syndrome was carried out. A large polyp of the ileum required enterotomy for its removal, and another smaller polyp of the upper jejunum was identified and removed by intra‐operative total enteroscopy via the anus. Intra‐operative enteroscopy allows one to identify polyps that would previously have been missed. A more complete polypectomy can be performed using this technique, allowing the patient with Peutz‐Jegher's syndrome a longer interval between laparotomies and a reduction in symptoms attributed to polyps.