Abdominal pain

A 26-year-old man came into the emergency dept complaining of "abdominal pain for 7 hours." The patient had occasional abdominal pain for more than six months, and seven hours ago, the pain got severe and was followed by vomiting. There was no blood in the stool, and the patient had not lost any weight previously. His mother and sister also had Peutz-Jeghers syndrome (PJS), and his mother died from intestinal cancer. He had normal vital signs. On his lips, palms, and soles of his feet, mucocutaneous pigmentation was seen (Fig. 1). Intestinal wall was edematous and enlarged on computed tomography (CT) of the abdomen (Fig. 2a). There were mild high-density shadow alterations in the bowel. The small intestine of around groups 4 and 5 in the left middle and lower abdominal region had concentric circles abnormalities (Fig. 2b). Peutz-Jeghers syndrome (PJS) was the official diagnosis for the patient.