Peroperative Ileojejunoscopy in Peutz-Touraine-Jeghers Syndrome

Prognosis of the Peutz-Touraine-Jeghers syndrome is determined in part by intestinal hamartomas, complications and iterative surgery morbidity. This can involve, by successive intestinal resections, a ‘short bowel syndrome’. If the colonic tumors are treated by endoscopy, ileojejunal localizations require multiple enterotomies. Three patients with Peutz-Touraine-Jeghers syndrome have been treated by peroperative endoscopy: in two cases after a colectomy (for multiple colonic polyps nonremovable by endoscopy in one case and for an associated colonic Crohn’s disease in another) and in one case by enterotomy. Peroperative ileojejunoscopy is especially adapted to diffuse intestinal lesions. The endoscope can be introduced either by enterotomy at the ileojejunal junction or after a resection (our 3 cases). No morbidity is due to this procedure. Peroperative use of ileojejunoscopy reduces surgery frequency by allowing the remoral of small bowel tumors otherwise inaccessible by conventional endoscopy.