A CLINICAL CASE OF SUCCESSFUL SURGERY OF A SECOND-TRIMESTER PREGNANT PATIENT WITH HEREDITARY GASTROINTESTINAL POLYPOSIS COMPLICATED BY INTUSSUSCEPTIVE SMALL-INTESTINAL OBSTRUCTION

Abstract. Introduction. One of the complications of hereditary gastrointestinal polyposis, including Peutz-Jeghers syndrome, is intussusception. Intussusception is the most common phenomenon in pediatric practice. This is a rare complication in adults with hereditary gastrointestinal polyposis. Only 2-3 intussusception surgery cases related to gastrointestinal polyposis during pregnancy were described in publications. In Russia, we have not found any publications describing successful surgeries of second-trimester pregnant patients with hereditary gastrointestinal polyposis complicated by small intestinal intussusception. Aim. To present a rare case of a successful surgery of a second-trimester pregnant patient with hereditary gastrointestinal polyposis complicated by intussusceptive small-bowel obstruction. Materials and Methods. A female patient, born in 1988, was admitted in the Gynecology Department of City Clinical Hospital No. 7 named after. M.N. Sadykov with the diagnosis of pregnancy II, 21-22 weeks, vomiting of pregnant women, a uterine scar, a burdened obstetric history, and mild anemia. A conservative treatment was carried out. The patient has suffered from the gastrointestinal polyposis since her childhood; she was followed up by an oncologist; polyps were removed endoscopically several times; the polyps were benign. Results and Discussion. Based on the examination findings, she was transferred to the Surgery Department with subsequent surgery for acute intussusception and small bowel obstruction and jejunal polyps. The postoperative period was complicated by the threat of premature birth, which was stopped in the Maternity Hospital, a few months later a healthy boy was born, the patient was subsequently examined by a surgeon, there were no complaints, the child was healthy, and recommendations were given. Macroscopic specimens histologically: Adenomatous polyps. Thus, in our opinion, despite the histological conclusion, the patient has PJS with a complicated course during pregnancy in form of intussusception and small bowel obstruction. Conclusions. Intussusception due to hereditary gastrointestinal polyposis in pregnant patients is an extremely rare acute surgical disease of abdominal organs. For diagnosis, along with clinical research methods and abdomen radiography, ultrasound and MRI should be used. Surgery is the main treatment method for intussusception due to hereditary gastrointestinal polyposis in pregnant patients