Akbulut S, Koc C, Dirican A. Unusual complication in patient with Gardner’s syndrome: Coexistence of triple gastrointestinal perforation and lower gastrointestinal bleeding: A case report and review of literature. World J Clin Cases 2018; 6(10): 393-397 [PMID: 30283802 DOI: 10.12998/wjcc.v6.i10.393]
Corresponding Author of This Article
Sami Akbulut, MD, Associate Professor, Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Elazig Yolu 10. Km, Malatya 44280, Turkey. akbulutsami@gmail.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 26, 2018; 6(10): 393-397 Published online Sep 26, 2018. doi: 10.12998/wjcc.v6.i10.393
Unusual complication in patient with Gardner’s syndrome: Coexistence of triple gastrointestinal perforation and lower gastrointestinal bleeding: A case report and review of literature
Sami Akbulut, Cemalettin Koc, Abuzer Dirican
Sami Akbulut, Cemalettin Koc, Abuzer Dirican, Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey
Author contributions: Akbulut S and Dirican A performed surgical procedure; Akbulut S and Koc C collected the patient’s clinical data; Akbulut S and Koc C analyzed the data and wrote the paper.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and accompanying images.
Conflict-of-interest statement: The author declares no potential conflict of interest
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sami Akbulut, MD, Associate Professor, Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Elazig Yolu 10. Km, Malatya 44280, Turkey. akbulutsami@gmail.com
Telephone: +90-422-3410660 Fax: +90-422-3410036
Received: May 18, 2018 Peer-review started: May 18, 2018 First decision: June 14, 2018 Revised: June 19, 2018 Accepted: June 28, 2018 Article in press: June 28, 2018 Published online: September 26, 2018
ARTICLE HIGHLIGHTS
Case characteristics
A 37-year old cachectic male patient was referred to our center with lower gastrointestinal bleeding.
Clinical diagnosis
Gardner’s syndrome (GS), lower gastrointestinal bleeding due to gastrointestinal polyposis.
Differential diagnosis
Bleeding due to colorectal cancer, bleeding due to colonic polyposis.
Conventional celiac and mesenteric angiographies that were performed to detect the hemorrhagic focus showed no extravasation that was indicative of bleeding.
Pathological diagnosis
Poorly-differentiated adenosquamous carcinoma of the colon, colorectal polyposis, duodenal polyposis, desmoid tumor.
Treatment
Resection of the distal duodenum and proximal jejunum, latero-lateral duodenojejunal anastomosis, total abdominal colectomy with end ileostomy, distal rectal stump closure, resection of the desmoid tumor-like lesions.
Related reports
To the best of our knowledge, no case of GS has ever been reported in the English language medical literature that presents with gastrointestinal perforation and bleeding.
Experiences and lessons
Although GS is a rare condition, it should be taken seriously since it may cause colorectal cancers until the age of 40. Therefore, close follow-up of GS patients and prophylactic surgery during early stages of GS are the most appropriate approaches. Patients who are diagnosed with upper gastrointestinal polyps should be closely examined by endoscopy. The case presented here clearly demonstrates that serious life-threatening complications like tumor perforation and massive bleeding may develop in neglected GS cases.
