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Deutsche Medizinische Wochenschrift 2003-May

[Cholestasis and vomiting: unusual differential diagnosis in a case of Peutz-Jeghers syndrome].

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F Mandraka
C Zuelke
G Lock

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METHODS

A 54-year-old patient with painless jaundice and vomiting had been diagnosed with a Peutz-Jeghers syndrome 20 years before.

METHODS

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.

METHODS

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.

CONCLUSIONS

This case demonstrates the potentially severe complications of a Peutz-Jeghers syndrome that had been neglected for years.

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