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Two patients with PJS presenting with acute small bowel obstruction underwent a short midline laparotomy with polypectomy as described below. The first patient was a 28-year-old man who had two jejuno-jejunal intussusceptions. The second patient was a 38-year-old man with multiple small bowel intussusceptions on his contrast enhanced CT scan. The classical muco-cutaneous hyperpigmentation was seen in both these patients, as shown in Fig. 1. On eliciting the history, we found out that the siblings of our second patient also suffered from PJS. They had suffered repeated intussusceptions on scans with large polyps which were being managed conservatively. They underwent an elective polypectomy using the same approach due to the unavailability of flexible enteroscopy at our centre.

Muco-cutaneous hyperpigmentation in a patient with Peutz-Jeghers Syndrome.

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