RESUMO
El manejo de los pólipos digestivos extracolónicos resulta controvertido en los pacientes con poliposis adenomatosa familiar (PAF). El tratamiento de los pólipos adenomatosos con displasia severa en el estómago mediante resecciones gástricas amplias puede dificultar el seguimiento posterior de la aparición de nuevos pólipos en el área duodenoyeyunal. Presentamos el caso excepcional de un varón de 45 años con PAF que desarrolló 2 pólipos adenomatosos sincrónicos, con displasia severa, uno en el antro gástrico y el otro en el yeyuno proximal. Se realizó una gastrectomía subtotal en «Y» de Roux y una resección del segmento yeyunal proximal, ante el diagnóstico preoperatorio de neoplasia gástrica con invasión de la pared (T2N0) (AU)
The management of extracolonic gastrointestinal polyps is controversial in patients with familial adenomatous polyposis (FAP). The treatment of adenomatous polyps with severe dysplasia in the stomach through wide gastric resections can hamper subsequent surveillance of the development of new polyps in the duodenal-jejunal area. We report the exceptional case of a 45-year-old man with FAP who developed two synchronic adenomatous polyps, with severe dysplasia. The first was located in the gastric antrum and the second in the proximal jejunum. Given the preoperative diagnosis of gastric neoplasm with invasion of the gastric wall (T2N0), subtotal Roux-en-Y gastrectomy and resection of the proximal jejunal segment were performed (AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Pólipos Intestinais/cirurgia , Polipose Adenomatosa do Colo/complicações , Coristoma/cirurgia , Neoplasias Primárias Múltiplas/cirurgiaRESUMO
The management of extracolonic gastrointestinal polyps is controversial in patients with familial adenomatous polyposis (FAP). The treatment of adenomatous polyps with severe dysplasia in the stomach through wide gastric resections can hamper subsequent surveillance of the development of new polyps in the duodenal-jejunal area. We report the exceptional case of a 45-year-old man with FAP who developed two synchronic adenomatous polyps, with severe dysplasia. The first was located in the gastric antrum and the second in the proximal jejunum. Given the preoperative diagnosis of gastric neoplasm with invasion of the gastric wall (T(2)N(0)), subtotal Roux-en-Y gastrectomy and resection of the proximal jejunal segment were performed.
