Intestinal Polyposis associated with Pigmentation and Intussusception in Triplets

Abstract

At laparotomy on May 30, 1949, an ileo-ileal intus- susception was reduced; no resection.On April 20, 1950, laparotomy revealed an irreducible ileo-ileal intussuscep- tion; 12 in.(30 cm.) of ileum was resected.In November, 1950, and January and July, 1951, he was admitted with intestinal obstruction and intussusceptions were palpated, but spontaneous reduction occurred shortly after admission.He often suffers from both mild and severe attacks of colic, but so far has required no further admission to hospital.CASE 2 A boy aged 12 attended in February, 1951, with a rectal polyp.He had had an operation for intussusception in 1939.There was no relevant family history.He was a sallow child with typical pigmentation of the lips and oral mucosa.A polyp was removed from the rectum.Barium enema and sigmoidoscopy revealed no further polyps at that time.A second polyp was removed in July 1951, and in May, 1952, examination revealed a third rectal polyp and mass in the ascending colon.An exploratory laparotomy on July 9, 1952, revealed a polyp in the jejunum, 12 in.(30 cm.) from the duodeno- jejunal flexure, a polypoid mass in the caecum, a polyp in the appendix, a polypoid mass in the descending colon, where a chronic intussusception was present, and a polyp in the sigmoid colon; the mucosa of tbp terminal ileum was nodular, but no true polyps were present.Resection of 6 in.(15 cm.) of upper jejunum and total colectomy, ana- stomosing the lower ileum to the rectum, were carried out.The pathological report stated " benign adenomatous polyps."Post-operative progress was complicated in October, 1952, by intestinal obstruction due to adhesions, which were divided.No further polyps have developed in the 4 in.(10 cm.) of rectum remaining.I wish to thank Mr. Ridley Thomas and Mr.