Intestinal intussusception in a 16-year-old teenager with Peutz-Jeghers Syndrome: a Case Report

Introduction Intestinal intussusception is rare in adolescents, accounting for approximately 3% of cases, whereas the majority of intussusceptions occurs in infants and toddlers under 3 years of age. Case Presentation A 16-year-old female presented with acute lower abdominal pain, vomiting and diarrhea. No medical history was reported other than Peutz-Jeghers syndrome. Her only gastroenterological evaluation, which included video capsule endoscopy, was performed seven years before and was normal. Physical examination revealed a painful, palpable mass in the lower abdomen. Vital signs were normal. Blood work showed hypokalemia at 2.5mmol/L (normal range: 3.5-5.0mmol/L), elevated lactate at 3.80mmol/L (normal range: <2mmol/L) and LDH at 234U/L (normal range: 135-214U/L). A contrast-enhanced CT revealed the typical target sign of ileo-ileal intussusception. We decided to operate to surgically reduce the intussusception. Due to severe necrosis of the affected bowel segment, we performed a partial enterectomy with hand-sewn ileo-ileal anastomosis. The postoperative course was uneventful, and the patient was discharged on postoperative day 5. Histopathology confirmed the diagnosis of a 17-cm-long ileal intussusception with the pathognomonic hamartomatous polyps of Peutz-Jeghers syndrome. The patient was referred to a gastroenterologist for long-term follow-up. Conclusion Patients with Peutz-Jeghers syndrome who develop acute abdominal pain must undergo imaging studies to rule out a polyp-related intussusception.