Juvenile polyposis of the stomach--a novel cause of hypergastrinemia.

Abstract

BACKGROUND:

A 38-year-old female presented with a 3-year history of postprandial abdominal pain, refractory nausea, vomiting and hematemesis. She appeared malnourished and her symptoms were refractory to previous treatment with acid-suppressive drugs, prokinetics and antiemetics. Her medical history was significant for a diagnosis of juvenile polyposis syndrome at the age of 14 resulting in a transverse colectomy, and a diagnosis of Crohn's disease in her residual colon at the age of 35 resulting in a total colectomy.

INVESTIGATIONS:

Physical examination, blood analysis, esophagogastroduodenoscopy with biopsy, abdominal endoscopic ultrasound, abdominal CT scan, MRI, 24 h urine analysis, MIBG scintigraphy, ocreotide scintigraphy, fluorodeoxyglucose-PET scan and genetic testing for defined polyposis syndromes (SMAD4, BMPR1A).

DIAGNOSIS:

Juvenile polyposis syndrome with outlet obstruction of the stomach and excessive hypergastrinemia.

MANAGEMENT:

Continuous acid-suppressive therapy, prokinetic therapy and total parenteral nutrition. Repetitive endoscopic polypectomy (also known as debulking) was performed twice and was followed by gastrectomy with duodenoesophageal anastomosis.

• Authors: Karen D Papay, Vincent G Falck, Steen S Poulsen, Remo Panaccione, Jens F Rehfeld, Martin A Storr
• Journal: Nature reviews. Gastroenterology & hepatology (Nat Rev Gastroenterol Hepatol) Vol. 7 Issue 10 Pg. 583-8 (Oct 2010) ISSN: 1759-5053 [Electronic] England
• PMID: 20808292 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antacids
• Gastrins

Topics

• Adult
• Antacids
• Endoscopy, Digestive System
• Female
• Gastrectomy
• Gastric Outlet Obstruction (complications, diagnosis)
• Gastrins (blood)
• Humans
• Intestinal Polyposis (complications, congenital, diagnosis)
• Neoplastic Syndromes, Hereditary
• Parenteral Nutrition