PDF(Pubmed)
Abstract：
UNASSIGNED: Despite being the longest and containing a greater proportion of the gastrointestinal tract\'s mucosal surface area, the small bowel is where <2 % to 5 % of gastrointestinal cancers can occur. Peutz-Jeghers syndrome is the rarest risk factor for the development of small intestinal cancers. Here we report a case of perforated poorly differentiated adenocarcinoma of the jejunum for which Peutz-Jeghers syndrome is identified.
METHODS: A 25-year-old male patient presented to the emergency department with generalized peritonitis caused by a perforated jejunal mass. The patient underwent an emergency exploratory laparotomy. There was 800 ml of thin pus in the peritoneal cavity and 5 cm by 6 cm perforated mass over the jejunum which extends to the mesentery. Palpable intraluminal polyps with an inverted serosal surface for some of them were identified. The pus was sucked out, and the mass was resected with its mesenteric lymph nodes and segments containing polyps. Subsequently, end-to-end hand-sewn anastomosis was performed, and the abdomen was closed. The histopathology report showed poorly differentiated adenocarcinoma, stage IIIC (PT3, PN2), and Peutz-Jeghers polyps, suggesting Peutz-Jeghers syndrome.
UNASSIGNED: Even though small bowel malignancy is a rare entity, early detection is a challenging issue, especially when it happens below the ligaments of the trietz. Surgical resection offers the only potential cure for small bowel malignancy.
CONCLUSIONS: We conclude that patients with long-term, nonspecific abdominal complaints are good candidates for evaluation and investigation without overlooking small bowel malignancy. Peutz-Jeghers syndrome was a potential risk factor in our case.
METHODS: A 25-year-old male patient presented to the emergency department with generalized peritonitis caused by a perforated jejunal mass. The patient underwent an emergency exploratory laparotomy. There was 800 ml of thin pus in the peritoneal cavity and 5 cm by 6 cm perforated mass over the jejunum which extends to the mesentery. Palpable intraluminal polyps with an inverted serosal surface for some of them were identified. The pus was sucked out, and the mass was resected with its mesenteric lymph nodes and segments containing polyps. Subsequently, end-to-end hand-sewn anastomosis was performed, and the abdomen was closed. The histopathology report showed poorly differentiated adenocarcinoma, stage IIIC (PT3, PN2), and Peutz-Jeghers polyps, suggesting Peutz-Jeghers syndrome.
UNASSIGNED: Even though small bowel malignancy is a rare entity, early detection is a challenging issue, especially when it happens below the ligaments of the trietz. Surgical resection offers the only potential cure for small bowel malignancy.
CONCLUSIONS: We conclude that patients with long-term, nonspecific abdominal complaints are good candidates for evaluation and investigation without overlooking small bowel malignancy. Peutz-Jeghers syndrome was a potential risk factor in our case.
摘要：
■尽管胃肠道粘膜表面积最长且比例较大，小肠是<2％至5％的胃肠道癌症发生的地方。Peutz-Jeghers综合征是小肠癌发展的最罕见的危险因素。在这里，我们报告了一例空肠穿孔的低分化腺癌，其中发现了Peutz-Jeghers综合征。
方法：一名25岁男性患者因空肠穿孔性包块引起的全身性腹膜炎就诊至急诊科。患者接受了紧急剖腹探查术。腹膜腔内有800毫升薄脓，空肠上有5厘米×6厘米的穿孔肿块，延伸到肠系膜。确定了其中一些具有倒置的浆膜表面的可触及的管腔内息肉。脓液被吸出来了,切除肿块，肠系膜淋巴结和含有息肉的部分。随后，进行端对端手工缝合吻合，腹部闭合。组织病理学报告显示低分化腺癌，IIIC级(PT3,PN2),和Peutz-Jeghers息肉,提示Peutz-Jeghers综合征.
■尽管小肠恶性肿瘤是一种罕见的实体，早期检测是一个具有挑战性的问题，尤其是当它发生在Trietz的韧带下方时。手术切除是治疗小肠恶性肿瘤的唯一潜在方法。
结论：我们得出结论，非特异性腹部主诉是评估和调查的理想选择,且不会忽视小肠恶性肿瘤.在我们的病例中，Peutz-Jeghers综合征是一个潜在的危险因素。
方法：一名25岁男性患者因空肠穿孔性包块引起的全身性腹膜炎就诊至急诊科。患者接受了紧急剖腹探查术。腹膜腔内有800毫升薄脓，空肠上有5厘米×6厘米的穿孔肿块，延伸到肠系膜。确定了其中一些具有倒置的浆膜表面的可触及的管腔内息肉。脓液被吸出来了,切除肿块，肠系膜淋巴结和含有息肉的部分。随后，进行端对端手工缝合吻合，腹部闭合。组织病理学报告显示低分化腺癌，IIIC级(PT3,PN2),和Peutz-Jeghers息肉,提示Peutz-Jeghers综合征.
■尽管小肠恶性肿瘤是一种罕见的实体，早期检测是一个具有挑战性的问题，尤其是当它发生在Trietz的韧带下方时。手术切除是治疗小肠恶性肿瘤的唯一潜在方法。
结论：我们得出结论，非特异性腹部主诉是评估和调查的理想选择,且不会忽视小肠恶性肿瘤.在我们的病例中，Peutz-Jeghers综合征是一个潜在的危险因素。
