TOWARDS DECREASING THE RELAPAROTOMY RATE IN THE PEUTZ-JEGHERS SYNDROME - THE ROLE OF PEROPERATIVE SMALL-BOWEL ENDOSCOPY

Relaparotomy occurs commonly in patients with the Peutz–Jeghers syndrome, and at quite short intervals. Between 1943 and 1987 laparotomies were performed on 54 occasions in 23 patients with the Peutz–Jeghers syndrome who at some time came under the care of St. Mark's Hospital. In four patients repeat laparotomy was performed within a single year. Between 1987 and 1989 a further five patients have undergone laparotomy with on‐table small bowel endoscopy. External palpation and small bowel transillumination failed to demonstrate 17 out of a total of 45 hamartomas (38 per cent). Of these 17 polyps identified endoscopically, 11 (65 per cent) were sufficiently large that a snare was used to remove them. We recommend peroperative enteroscopy as an adjunct to surgery in the Peutz–Jeghers syndrome. Copyright © 1990 British Journal of Surgery Society Ltd.