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Endoscopy 1999; 31(6): 472-478
DOI: 10.1055/s-1999-47
Review
Georg Thieme Verlag Stuttgart ·New York

Management of Duodenal Adenomas in Familial Adenomatous Polyposis

J. C. Saurin, J. A. Chayvialle, T. Ponchon
  • Fédération des Spécialités Digestives, Hôpital Edouard Herriot, Lyon
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Publication History

Publication Date:
31 December 1999 (online)

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Introduction

Familial adenomatous polyposis (FAP) is an uncommon inherited disease, found in about 1/8000 births, which leads to the development of adenomas throughout the glandular digestive mucosa. The main complication of this disease is colorectal cancer, which is prevented by prophylactic colectomy carried out in most patients during the third decade. After colectomy, these patients remain at risk for life-threatening complications related to the disease. The two major complications are desmoid tumors (mesenchymal, nonmalignant, mostly mesenteric, slow-growing tumors), and duodenal adenocarcinomas, mostly periampullary [1] [2] . These probably develop from duodenal adenomas, which are present in the large majority of FAP patients. In clinical practice, there is a strong contradiction between the recommended endoscopic surveillance of duodenal adenomas, which demonstrates their evolving nature, and the lack of therapeutic indications until the development of late-stage polyposis which may require pancreaticoduodenectomy.

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J. C. SaurinM.D. 

Fédération des Spécialités Digestives

Hôpital Edouard Herriot

Pavillon O

5 place d'Arsonval

69437 Lyon Cedex

France

Phone: + 33-472-110147

Email: saurin@lyon151.inserm.fr