Colonic inflammatory fibroid polyp (IFP) is an uncommon benign polypoid lesion, which is composed of fibroblasts, numerous small vessels and edematous connective tissue with marked eosinophilic inflammatory cell infiltration. This condition is frequently detected in the stomach and small intestine, but uncommon in the colon. Although IFP is a benign lesion, surgical resections are performed in most colonic cases because the polyps are usually too large to resect endoscopically. Only three patients underwent endoscopic polypectomy in our literature reviews. Here, we present a case of IFP in the descending colon successful endoscopically resected using a novel technique of trapping its stalk with an endoloop, forming the stalk into an omega shape, and then dissecting the stalk with a needle knife.
Adult ; Colectomy ; Colonic Polyps/*pathology/*surgery ; Colonoscopy/*methods ; Female ; Humans ; Leiomyoma/pathology/*surgery

Colonoscopy with endoscopic resection of detected colonic adenomas interrupts the adenoma-carcinoma sequence and reduces the incidence of colorectal cancer and cancer-related mortality. In the past decade, there have been significant developments in instruments and techniques for endoscopic polypectomy. Guidelines have been formulated by various professional bodies in Europe, Japan and the United States, but some of the recommendations differ between the various bodies. An expert professional workgroup under the auspices of the Academy of Medicine, Singapore, was set up to provide guidance on the endoscopic management of colonic polyps in Singapore. A total of 23 recommendations addressed the following issues: accurate description and diagnostic evaluation of detected polyps; techniques to reduce the risk of post-polypectomy bleeding and delayed perforation; the role of specific endoscopic resection techniques; the histopathological criteria for defining endoscopic cure; and the role of surveillance colonoscopy following curative resection.
Adenoma/surgery* ; Colonic Neoplasms/surgery* ; Colonic Polyps/surgery* ; Colonoscopy/methods* ; Colorectal Neoplasms/pathology* ; Humans ; Singapore ; United States

Colonic hamartomas are rare polypoid lesions. We report an unusual case of multiple colonic hamartomatous polyps, including a giant hamartoma, unrelated to hereditary or familial polyposis syndromes, in a 48-year-old man. The diameter of the largest polyp was 9.5 cm, and endoscopy revealed that the lesion caused colonic obstruction. The clinical, endoscopic and histological aspects of this case are discussed.
Middle Aged ; Male ; Intestinal Obstruction/*pathology/surgery ; Humans ; Hamartoma/*pathology/surgery ; Colonoscopy ; Colonic Polyps/*pathology/surgery ; Colonic Diseases/*pathology/surgery ; Colectomy

Adolescent ; Colon, Ascending ; pathology ; Colonic Neoplasms ; pathology ; surgery ; Colonic Polyps ; pathology ; surgery ; Diagnosis, Differential ; Follow-Up Studies ; Ganglioneuroma ; pathology ; surgery ; Humans ; Male

BACKGROUND/AIMS: Surveillance of individuals with colon polyps is important for the prevention of colon cancer, and its interval is based on the clinical status. Our aims were to determine the recurrence rate of advanced polyp after polypectomy and estimate the adequate interval of surveillance colonoscopy as well as the risk factors of recurrence in Korea. METHODS: Ninety-seven patients who underwent follow-up colonoscopy after initial colonoscopic polypectomy were retrospectively studied. All polyps were endoscopically removed with electrocautery. RESUTLS: Mean number of initial polyps were 2.2 and advanced polyps were observed in 40% of the patients. The cumulative recurrence rate of colon polyp was 13.8% within 1 year, and 60% within 3 years, while that of advanced polyps was 2.5% and 31% within 1 and 3 years, respectively. The significant difference was noted according to the initial polyp number in both overall and advanced polyp recurrence rate. The age at the diagnosis of colon polyps was a significant factor only in overall polyp recurrence rate. Patients who initially had one polyp showed 15% of advanced polyp recurrence within 3 years. CONCLUSIONS: Recurrence of advanced polyp is very rare within one year after polypectomy. Patients with single polyp have low risk and thus, their surveillance may be delayed beyond the standard 3 years. When surveillance colonoscopy is to be performed for the patients with 2 or more polyps, initial polyp number and age should be considered.
Aged ; Colonic Polyps/diagnosis/pathology/*surgery ; *Colonoscopy ; Electrocoagulation ; English Abstract ; Female ; Humans ; Male ; Middle Aged ; Recurrence

Evaluating predictive factors for high-risk adenomas at the third colonoscopy based on two prior colonoscopies may help evaluate high-risk adenoma at the third colonoscopy. We analyzed clinical data of 131 patients at Severance Hospital from January 1997 to January 2011. All of them underwent two subsequent colonoscopies after removal of adenomas during an initial colonoscopy. Among 20 patients with high-risk adenoma at the first and second colonoscopies, 10 (50%) patients had high-risk adenoma at the third colonoscopy. Among the 67 patients who had high-risk adenoma only once at the first or second colonoscopy, 15 (22.4%) patients had high-risk adenoma at the third colonoscopy but among the 44 patients without high-risk adenoma at the first and second colonoscopies, only 1 (2.3%) patient had high-risk adenoma at the third colonoscopy (P < 0.001). A multivariate time dependent covariate Cox regression analysis confirmed that high-risk adenoma at the first and/or second colonoscopy (HR, 9.56; 95% CI, 2.37-38.54; P = 0.002) was independent predictor of high-risk adenoma at the third colonoscopy. Given these findings, data from two prior colonoscopies, not one prior examination, may help identify high-risk populations at the third colonoscopy who require careful colonoscopic surveillance.
Adenoma/*surgery ; Aged ; Colonic Neoplasms/*surgery ; Colonic Polyps/pathology/surgery ; *Colonoscopy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Proportional Hazards Models ; Risk Factors

No abstract available
Colonic Neoplasms/complications/*pathology ; Colonic Polyps/complications/*pathology/surgery ; *Colonoscopy ; Gastrointestinal Hemorrhage/*etiology ; Hemangioma, Cavernous/complications/*pathology ; Humans ; Male ; Middle Aged

PURPOSE: Colonoscopic polypectomy and surveillance are important to prevent colorectal cancer and identify additional relative risk factors for adequate surveillance. In this study, we evaluated risk factors related to recurrent high-risk polyps during the surveillance of patients with high-risk polyps. MATERIALS AND METHODS: We included 434 patients who had high-risk polyps (adenoma > or =10 mm, > or =3 adenomas, villous histology, or high-grade dysplasia) on the baseline colonoscopy and underwent at least one surveillance colonoscopy from 2005 to 2011 at Severance Hospital. Data regarding patient characteristics, bowel preparation and polyp size, location, number, and pathological diagnosis were retrospectively collected from medical records. Patients with recurrent high-risk polyps were compared with patients with low-risk or no polyps during surveillance. RESULTS: Patients were predominantly male (77.4%), with a mean age of 61.0+/-8.6 years and mean follow-up of 1.5+/-0.8 years. High-risk polyps recurred during surveillance colonoscopy in 51 (11.8%) patients. Results of multivariate analysis showed that male gender, poor bowel preparation, and a larger number of adenomas were independent risk factors for recurrent high-risk polyps (p=0.047, 0.01, and <0.001, respectively). Compared with high-risk polyps found during initial colonoscopy, high-risk polyps on surveillance colonoscopy had higher proportions of small adenomas, low-risk pathology, and fewer adenomas overall, but there was no difference in location. CONCLUSION: Male patients and those with poor bowel preparation for colonoscopy or higher numbers of adenomas were more likely to experience recurrent high-risk polyps.
Adenomatous Polyps/pathology/*surgery ; Aged ; *Colectomy ; Colonic Neoplasms/*pathology ; Colonic Polyps/pathology/*surgery ; *Colonoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local/*diagnosis ; Retrospective Studies ; Risk Factors

Colonic arteriovenous malformation (AVM) is one of the causes of lower gastrointestinal bleeding. Unlike small vascular ectasia or angiodysplasia, colonic AVM tends to be solitary, large in size, and identified endoscopically as flat or elevated bright red lesion. Herein, we report a case of non-solitary and small cecal AVMs which were removed by endoscopic biopsy. A 66-yr-old woman was referred for routine gastrointestinal cancer screening. She was suffering from diabetes, hypertension, end-stage renal disease, and anemia of chronic disease. On colonoscopic finding, three semi-pedunculated polyps, less than 5 mm in size, were noticed near to the appendiceal orifice. Since the lesions revealed normal-looking epithelium with converging folds on the cecal base, lesions were diagnosed as inflammatory polyps on gross finding. Three biopsies were taken from each lesion. Bleeding from the biopsied site ceased spontaneously. Histopathologic evaluation demonstrated intramucosal hemorrhage and dilated submucosal vessels which were consistent with polypoid colonic AVMs.
Aged ; Arteriovenous Malformations/*diagnosis/pathology/surgery ; Biopsy ; Cecum/blood supply/pathology ; Colon/*blood supply/pathology ; Colonic Polyps/pathology/*surgery ; Colonoscopy ; Female ; Humans

OBJECTIVE: To study the age, clinical, enteroscopic and pathological characteristics of colorectal polyps and factors affected polyp-carcinoma. METHODS: We analyzed the clinical, enteroscopic and pathological characteristics of 7276 cases of colorectal polyps. RESULTS The incidence of colorectal polyps was 10.94%, including 521 men and 275 women. The rate of colorectal polyp was 82.29% in 30-69 year olds. The adenomatous, inflammatory, hyperplastic and juvenile polyps were 43.84%, 42.09%, 11.06% and 1.51%, respectively. Polypoid lesions were located at cecum 3.29%, ascending 11.88%, transverse 4.89%, descending 11.58%, sigmoid 26.05%, and rectum 42.32%. Thirty-five cases (4.4%) were found to have polpous canceration. The canceration rates in villous, mixed and tubular adenomas were 29.73%, 11.11%, and 4.86%. The rate of canceration seemed to depend on its dimensions, being 1.3%, 7.4%, and 25.6% for the 0.6 - 1.0 cm, 1.1 - 1.9 cm, and > or = 2.0 cm in size, respectively. Conclusion The ages between 30-69 tend to suffer from colorectal polyps. The incidence in the male is higher than that in the female. Colorectal polyps are more likely to locate in left colon. The common pathological types were adenomatous and inflammatory polyps. There is a high canceration of polyps in the left colon, villous adenomas and > or = 2.0 cm polyps. The broader the pedicles and the larger the diameters of polyps are, the higher the canceration rate. All of the colon polyps should be excised and undergo the pathological examination. Enteroscopic polypectomy helps prevent colorectal polpous canceration.
Adenoma ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cell Transformation, Neoplastic ; pathology ; Child ; Child, Preschool ; Colonic Polyps ; pathology ; surgery ; Colonoscopy ; Colorectal Neoplasms ; pathology ; surgery ; Female ; Humans ; Intestinal Polyps ; pathology ; surgery ; Male