Small bowel intussusception caused by a solitary Peutz-Jeghers-type polyp

Intussusception with a pathological lead point (PLP) is rare in children, and diagnosis is often challenging. We experienced a 3-year-old boy with small bowel intussusception due to a solitary polyp of the Peutz-Jeghers (P-J) -type. The preoperative contrast-enhanced computed tomography (CT) scan clearly showed the PLP. Emergency laparotomy was performed, and approximately 50 cm of the necrotic part of the small bowel containing the polyp was resected. The postoperative course was uncomplicated. The case indicates that contrast-enhanced CT scan is useful for confirming not only intussusception but also the PLP. In terms of regular follow up, differential diagnosis of solitary P-J-type polyps from P-J syndrome is important.

Automated summary

Intussusception with a pathological lead point is rare in children. This case report describes a 3-year-old boy with small bowel intussusception caused by a solitary polyp of the Peutz-Jeghers (P-J) type. Preoperative CT scan clearly showed the pathological lead point. Emergency laparotomy was performed and the necrotic part of the small bowel containing the polyp was resected. Postoperative recovery was uneventful. The case highlights the usefulness of contrast-enhanced CT scan in confirming both intussusception and the pathological lead point, and the importance of distinguishing solitary P-J-type polyps from P-J syndrome during regular follow-up.