1/24. Sonographic appearances of conglomerated polyps (giant polyposis) in patients with Crohn's disease.Giant polyposis is a rare presentation of Crohn's disease (CD) of the colon and can be misdiagnosed as colon cancer. To our knowledge, the sonographic characteristics of conglomerated polyps in colonic CD have not been published. The purpose of this article is to describe sonographic findings in 3 patients with giant polyposis and evaluate the contribution of sonography in establishing this diagnosis. We conclude that sonography can facilitate the diagnosis of giant polyposis in CD by demonstrating associated findings in the large and small bowels that are suggestive of CD.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/24. Filiform polyposis of the colon in chronic inflammatory bowel disease (so-called giant inflammatory polyps).On the basis of 3 of our own cases, we describe unusually intense forms of filiform polyposis and local giant polyposis as a consequence of chronic inflammatory bowel disease. The patients are: A 52-year-old woman who for 7 years has been known to have Crohn's disease (CD); a 55-year-old man who for 14 years has been known to have chronic inflammatory bowel disease, which was first thought to have been ulcerative colitis, but, as a result of the findings on the subtotal colectomy specimen, had to be classified as Crohn's disease or colitis indeterminate; and a 53-year-old woman known to have had ulcerative colitis for 37 years. From the literature on the subject, we drew up a chronological list of a total of 43 cases with similar or completely identical findings. The clinical significance of the findings in their particularly massive intensity results from their necessary differentiation--in the context of differential diagnosis--from a malignant tumor, in particular from a carcinoma in association with chronic inflammatory bowel disease, or from a villous adenoma. The indication of a need to operate results from the impossibility of being able definitely to rule out a malignant degeneration by means of clinical methods. Also, experience shows that with massive findings of the kind described a spontaneous disappearance cannot be expected. Finally, too, the clinical symptoms and the patients subjective complaints necessitate balanced surgical treatment, taking into consideration the site and the extent of the lesion.- - - - - - - - - - ranking = 0.83333333333333keywords = giant (Clic here for more details about this article) |
3/24. Lipomatous polyposis of the colon with multiple lipomas of peritoneal folds and giant diverticulosis: report of a case.A case of multiple lipomatosis exclusively located in the colon is reported in a young male (33 years). It is characterized by a great number of lipomas with polyposis growth appearance, multiple lipomas of peritoneal folds, and giant diverticulosis probably caused by weakened areas of colonic wall induced by the lipomas.- - - - - - - - - - ranking = 0.83333333333333keywords = giant (Clic here for more details about this article) |
4/24. Localized giant pseudopolyposis in ulcerative colitis.Localized giant pseudopolyposis is an interesting but unusual manifestation of both ulcerative colitis and Crohn's disease. The purpose of this report is to present a case of localized giant pseudopolyposis complicating an ulcerative colitis, and review other cases reported in the literature. The clinical and pathological findings are described. The authors also discuss the possible aspect of proper management in this type of lesion.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/24. Giant inflammatory polyposis of the descending colon associated with a Crohn's disease-like colitis.A case of giant inflammatory polyposis associated with a localized inflammatory bowel disease of the descending colon in a 49-year-old man is presented. Lower abdominal distension rapidly appeared without any previous history of gastrointestinal disease. Two months later, he underwent a left hemicolectomy. Postoperative recovery was complete and he remains in good health more than 2 years later. The resected colon showed a giant and bizarre polyposis measuring up to 12 cm in length and 2 cm in height and covering the entire circumference of the colon. The polyposis consisted of narrow worm- or noodle-like polyps that bridged over the irregularly shaped ulcers, which sometimes extended into muscularis propria. Although longitudinal ulcers or scars, stricture, and a cobble-stone appearance were not observed, transmural inflammation and deep fissures were found in the interpolypoid area. From these findings, this case seems to be more similar to Crohn's disease than other inflammatory bowel diseases.- - - - - - - - - - ranking = 0.33333333333333keywords = giant (Clic here for more details about this article) |
6/24. 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.- - - - - - - - - - ranking = 0.16666666666667keywords = giant (Clic here for more details about this article) |
7/24. Colocolonic intussusception of a giant pseudopolyp in a patient with ulcerative colitis: a case report and review of the literature.adult intussusception in the setting of inflammatory bowel disease (IBD) is a rare phenomenon. Giant pseudopolyps, while generally considered benign, may function as lead points for intussusception. diagnosis and management of intussusception in the setting of IBD can be fraught with hazards. We report the case of a 27-year-old male, recently diagnosed with ulcerative colitis and giant pseudopolyps, who presented with colocolonic intussusception and obstruction. diagnosis was confirmed using CT imaging and the patient underwent resection of the colocolonic intussusception without reduction. The following case underscores the challenges in managing adult intussusception in the setting of IBD and allows for a review of the literature to date. Resection of non-reduced intussusception, rather than endoscopic or enema reduction, should continue to be definitive treatment of patients presenting with this unusual problem.- - - - - - - - - - ranking = 0.83333333333333keywords = giant (Clic here for more details about this article) |
8/24. Occult cancer in localized giant pseudopolyposis.Localized giant pseudopolyposis is a rare complication in patients with ulcerative colitis which progresses to a huge intramural polypoid mass. Our case described here is a 30-yr-old female with chronic ulcerative colitis who developed localized giant pseudopolyposis with unexpected infiltrating adenocarcinoma. This case is one of an unusual form of cancer presentation in ulcerative colitis, and it indicates that we should be aware of the possibility of occult adenocarcinoma inside a large pseudopolyposis with no superficial dysplasia.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/24. Diffuse giant inflammatory polyposis: a challenging clinicopathologic diagnosis.Giant inflammatory polyposis of the colon is an uncommon manifestation of inflammatory bowel disease. We report a unique case of localized diffuse giant inflammatory polyposis in a 58-year-old white man, which was characterized by recurrence following initial surgical resection. The patient presented with symptoms of abdominal pain and passing blood per rectum. Colonoscopic examination revealed a near-obstructing, "fungating" mass in the sigmoid colon, which clinically was thought to represent colon carcinoma. histology of several colon biopsies revealed marked acute inflammation with microabscess formation of the polyps and the adjacent mucosa. There was no evidence of dysplasia or malignancy. Because malignancy was strongly suspected and to relieve the obstructive symptoms, the patient underwent a segmental colectomy. The histologic features of the resected mass showed giant polyps with acute inflammation diagnostic of giant inflammatory polyposis. Again, there was no evidence of malignancy. Seven months later, following an uneventful initial postoperative recovery, the patient developed a recurrence of the mass with obstructive symptoms and required further surgical resection. The gross and histologic features of the lesion were similar to the previous findings. This case highlights the varied presenting symptoms and deceptive gross colonoscopic and radiologic features of localized diffuse giant inflammatory polyposis. Finally, the presence of inflammation at the resection margins appears to predict recurrence or persistence of the disease.- - - - - - - - - - ranking = 1.3333333333333keywords = giant (Clic here for more details about this article) |
10/24. Colonic obstruction due to giant inflammatory polyposis in a patient with ulcerative colitis.A 32-year-old Japanese woman with a 14-month history of ulcerative colitis (UC), pancolitis type, was referred to our institution, because of abdominal distention. Plain abdominal X-ray and computed tomography (CT) showed marked dilatation of the right side of the colon. The patient was treated by immediate total colectomy, with the diagnosis of toxic megacolon. Macroscopically, there was a constricting lesion with giant polyposis in the middle part of the transverse colon. Histologically, there was transmural inflammation with a thickened proper muscular layer overlaid by inflammatory polyposis. This case suggests that giant polyposis in UC patients may result in severe stenosis and that such a condition should not be misinterpreted as toxic megacolon or as colitic cancer.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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