Pseudopolyps in Inflammatory Bowel Disease: Complications and Developing-Associated Factors

Aims Pseudopolyp (PP)are considered as indicators of previous episodes of severe inflammation. The reasons that a specific group of inflammatory bowel disease (IBD)patients develop PP remain unclear. Our study aimed at describing the characteristics of patients with PP and at investigating the associated factors of their occurrence as well as their possible complications.

Methods A retrospective single-center study was conducted,including consecutive patients with IBD from 2011 to 2020.Patients with isolated ileal Crohn’s disease (CD)or with operated colon were not eligible for the study.Data about demographic characteristics, severity, and extension of the underlining IBD, endoscopic and histological features of PP were collected. Results were analyzed with SPSS22.

Results Sixty patients were included(median age:36.5y. (14-71y.); 31 females and 29males).The underlining disease was ulcerative colitis (UC)in 52.5 % of cases and CD in 74.5 %. Twenty seven patients (45 %) developed PP after a median delay of 48 mo. (0-391 mo.)from the date of diagnosis of the IBD.PP were complicated in 36 % of cases by: iron deficiency anemia, bleeding, obstruction and protein-losing enteropathy in 7, 4, 4 and 3 patients respectively. The PP were mainly located in the left colon (44.4 %). They were disseminated in the whole colon in 33.3 % and confined in the rectosigmoid in 33 % of cases respectively. The majority of PP (70 %) were sessile with an inflammatory mucosal surface. The medium size of PP was 5.5 mm (2-30mm). Giant filiform PP were seen in 22.2 % of cases. Histology revealed acute and chronic inflammation similar to the neighboring areas of the colon in all cases. Dysplasia features were noted in three cases of biopsied specimens from non suspected polyps. Prevalence of PP is alike in both sexes(p =0.44). The occurrence of PP was significantly higher on an underlining UC (p=0.018), with a severe course (p=0.017). Neither the extent nor the duration of IBD did significantly influence the incidence of PP.

Conclusions The incidence of PP is relatively high in IBD patients. They were symptomatic in a third of patients. A severe UC is likely the most associated condition to the presence of PP. Dysplasia was exceptional.

Citation: Ghribi M, Laabidi S, Bouchabou B etal. eP260 PSEUDOPOLYPS IN INFLAMMATORY BOWEL DISEASE: COMPLICATIONS AND DEVELOPING-ASSOCIATED FACTORS. Endoscopy 2021; 53: S183.

Publication History

Article published online:
19 March 2021