A Case of Solitary Peutz-Jeghers Type Hamartoma of the Jejunum with Bloody Stool and Intussusception

Tetsunobu Udaka, Kenzo Hori, Takashi Andou, Kazuhiro Tsuji, Masami Takagaki, Masaomi Yamane

Department of Surgery, Gastroenterological Center, Yashima General Hospital

A case of Peutz-Jeghers type solitary hamartoma of the jejunum with bloody stool and intussusception is reported. The patient was a 47-year-old man. He was examined in our hospital because of a chief complaint of bloody stool on October 2, 1996. Contrast roentgenography of the small intestine revealed a tumor in the jejunum. One week later, abdominal ultrasonography and CT showed target-shaped thickening of the small intestine suggesting intussusception of the small intestine. However, there were no symptoms in the abdomen. Reexamination by contrast roentgenography of the small intestine showed good passage and no intussusception of the small intestine. He was diagnosed as having intussusception caused by a tumor in the jejunum and received an operation on November 26. Intussusception of the jejunum, 50 cm from the ligament of Treitz, was found. After manual repositioning, a 20-cm length of the jejunum including the tumor was resected. The resected specimen showed a pedunculated tumor with a lobulated head. The pathological diagnosis was Peutz-Jeghers type hamartoma. Our case showed a interesting course that an asymptomatic intussusception caused by hamartoma naturally improved. As hamartomas are benign, jejunotomy and polypectomy are considered to be better method than resection of the jejunum.

Key words
hamartoma of jejunum, bloody stool, intussusception

Reprint requests
Tetsunobu Udaka Department of Surgery, Mitoya General Hospital
708 Himehama Toyohama-cho, Mitogo-gun, Kagawa, 769-1601 JAPAN

Accepted
September 16, 1998

To read the PDF file you will need Abobe Reader installed on your computer.