Endoscopic Snare Polypectomy for Bleeding Postinflammatory Polyps

We describe a patient with ulcerative colitis and protracted rectal bleeding who had required several blood transfusions and who was unresponsive to medical therapy, whose symptoms resolved after endoscopic resection of multiple giant postinflammatory polyps. This case report highlights the fact that postinflammatory polyps can occasionally cause significant symptoms, such as rectal bleeding, and that in these circumstances careful endoscopic polypectomy can be performed safely and result in a significant improvement in symptoms over a prolonged period of follow-up.

References

• 1 Levine D S, Surawicz C M, Spencer G D. et al . Inflammatory polyposis two years after ischemic colon injury.  Dig Dis Sci. 1986;  31 1159-1657
• 2 Kelly J K, Gabos S. The pathogenesis of inflammatory polyps.  Dis Colon Rectum. 1987;  30  251-254
• 3 Adelson J W, de Chadarevian J P, Azouz E M, Guttman F M. Giant inflammatory polyposis causing partial obstruction and pain in “healed” ulcerative colitis in an adolescent.  J Pediatr Gastroenterol Nutr. 1988;  7 135-140
• 4 Teague R H, Read A E. Polyposis in ulcerative colitis.  Gut. 1975;  6 792-795
• 5 Balazs M. Giant inflammatory polyps associated with idiopathic inflammatory bowel disease. An ultrastructural study of five cases.  Dis Colon Rectum. 1990;  33 773-777
• 6 Hinrichs H R, Goldman H. Localized giant pseudopolyps of the colon.  JAMA. 1968;  205 248-249
• 7 Goldgraber M B. Pseudopolyps in ulcerative colitis.  Dis Colon Rectum. 1965;  8 355-363
• 8 Jalan K N, Walker R J, Sircus W. et al . Pseudopolyposis in ulcerative colitis.  Lancet. 1969;  2 555-559
• 9 de Dombal F T, Watts J M, Watkinson G, Goligher J C. Local complications of ulcerative colitis: stricture, pseudopolyposis, and carcinoma of colon and rectum.  BMJ. 1966;  5501 1442-1447
• 10 Bryan R L, Newman J, Alexander-Williams J. Giant inflammatory polyposis in ulcerative colitis presenting with protein-losing enteropathy.  J Clin Pathol. 1990;  43 346-347
• 11 Fitterer J D, Cromwell L G, Sims J E. Colonic obstruction by giant pseudopolyposis.  Gastroenterology. 1977;  72 53-156
• 12 Forde K A, Gold R P, Hoick S. et al . Giant pseudopolyposis in colitis with colonic intussusception.  Gastroenterology. 1978;  75 1142-1146
• 13 Waye J D. New methods of polypectomy.  Gastrointest Endosc Clin N Am. 1997;  7 413-422