Diagnostic and therapeutic value of double-balloon enteroscopy in pediatric patients with Peutz-Jeghers syndrome.
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BACKGROUND: Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant disorder characterized by mucocutaneous pigmentation and gastrointestinal hamartomatous polyposis, with a particularly high predilection for the small intestine. These polyps carry significant risks of intussusception, bleeding, and malignant transformation, making effective surveillance and intervention essential in affected children. This study aimed to evaluate the diagnostic and therapeutic value of double-balloon enteroscopy (DBE) in children with PJS. METHODS: Clinical data were retrospectively collected from 22 children diagnosed with PJS who underwent DBE at Anhui Provincial Children's Hospital between March 2024 and October 2025. The analyzed parameters included sex, age, duration of enteroscopy, examination approach, depth of insertion, number of polyps resected intraoperatively, intraoperative blood loss, postoperative complications, and length of hospital stay. Statistical analyses were performed for all variables. RESULTS: Among the 22 pediatric patients, 16 were male and 6 were female, with a mean age of 11.35±3.96 years. The median duration of enteroscopy was 157.0 (90.75-253.5) minutes. An oral-only approach was performed in 7 patients, an anal-only approach in 5 patients, and combined oral and anal approaches in 10 patients. The mean insertion depth via the oral approach was 202.5±30.66 cm distal to the ligament of Treitz, whereas the mean insertion depth via the anal approach was 173.33±26.37 cm proximal to the ileocecal junction. A total of 76 polyps were resected using the oral approach and 135 polyps using the anal approach. One patient presented with a broad-based polyp located in the descending portion of the duodenum, which necessitated conversion to open laparotomy for polypectomy. Overall, 211 polyps were resected across all pediatric patients. The median intraoperative blood loss was 2.0 (1.0-2.0) mL per patient, and the mean postoperative hospital stay was 7.50±2.67 days. No postoperative gastrointestinal bleeding, intestinal perforation, or severe infectious complications were observed. CONCLUSIONS: DBE is a safe and feasible technique for the resection of multiple intestinal polyps in children with PJS. Compared with traditional open laparotomy, DBE offers advantages including scar-free healing, reduced surgical trauma, and improved postoperative recovery. These findings indicate that DBE has substantial clinical value and supports its broader application in pediatric clinical practice.