Peutz–Jegher Syndrome Complicated by Intussusception in a Patient with Incidental COVID-19 Infection: A Case Report.

Abstract

Peutz-Jegher syndrome (PJS) is an rare inherited disorder passed down in an autosomal dominant manner, characterized by gastrointestinal hamartomatous polyps, mucocutaneous pigmentation, and an increased risk of malignancies.

It typically presents with intestinal obstruction and intussusception, which are caused by gastrointestinal polyps acting as the pathological lead point around 70% of PJS patient. We report a case of an 11-year-old male with a family history of Peutz-Jegher syndrome (PJS), whose sister has been diagnosed with the condition. He presented to the emergency department with sudden abdominal pain and vomiting. Clinical examination revealed multiple dark freckles on the lips and generalized abdominal tenderness. Incidentally, his Coronavirus disease-19 (COVID-19) PCR test was positive. Contrast enhanced CT imaging indicated a small bowel obstruction likely caused by intussusception. The patient underwent emergency laparotomy, which confirmed jejuno-jejunal intussusception with gangrenous small bowel and multiple pedunculated polyps within the jejunum. The affected segment of the small intestine was resected, and primary anastomosis was performed. In conclusion, prompt recognition of intussusception is crucial, and appropriate radiological investigations are essential for accurate diagnosis and effective management.