[Juvenile gastric polyposis: differential diagnosis for recurrent nausea, vomiting, upper abdominal pain and diarrhoea] Deutsche medizinische Wochenschrift (1946) [Dtsch Med Wochenschr] Journal article | | Title | [Juvenile gastric polyposis: differential diagnosis for recurrent nausea, vomiting, upper abdominal pain and diarrhoea] | | Author(s) | Stöwhas M, Dommisch K, Sauer J | | Institution | Klinik für Allgemein- und Viszeralchirurgie, HELIOS Kliniken Schwerin, 19055 Schwerin, Germany. mathias.stoewhas@helios-kliniken.de | | Source | Dtsch Med Wochenschr 2009 Oct; 134(43):2170-3. | | MeSH | Abdominal Pain
Adenomatous Polyposis Coli
Colic
Diarrhea
Female
Gastrectomy
Gastric Outlet Obstruction
Gastroscopy
Humans
Middle Aged
Nausea
Stomach
Vomiting
| | Abstract | HISTORY AND ADMISSION
FINDINGS: A 46-year-old woman presented with nausea and vomiting, colics and localized pain in the upper abdomen. There was a family history of juvenile polyposis (3 of 4 siblings). Twelve years ago a colectomy had been performed in the patient for a gastric mucosal polyps.
INVESTIGATIONS: The physical examination showed a nearly normal BMI of 20,9 kg/m2. Gastroscopy showed polyps prolapsed into the duodenum, some of them incarcerated causing the listed symptoms.
DIAGNOSIS, TREATMENT AND COURSE: Because of progressing symptoms a total gastrectomy of a huge stomach was performed. Antral polyps were found to have prolapsed through the pylorus, causing gastric outlet obstruction. Histology confirmed juvenile polyposis. There was no evidence of a malignant process.
CONCLUSIONS: Juvenile polyposis is a rare inherited disease. Polyps can affect the entire gastrointestinal tract but predominantive in the colon. The clinic course of the juvenile polyposis is highly variable, but generally benign. Although malignant degeneration has been reported. A cumulative risk of malignant degeneration for the entire gastrointestinal tract has been estimated as being between 10 and 50 %, but it is very rare in the upper gastrointestinal tract. People with juvenile polyposis should have regular endoscopic controls. But if endoscopic control are impossible, total gastrectomy with lymphadenectomy may sometimes be necessary. Even after such extensive resection the patient may remain without symptoms. | | Language | ger | | Pub Type(s) | Case Reports
English Abstract
Journal Article
| | PubMed ID | 19826979 |
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