colonic polyps (B)

Question 1

Definition

Answer 1

Colorectal polyps are projections arising from the colonic mucosal surface that may be neoplastic or non-neoplastic; histopathology is required to confirm the nature of the polyp.

Question 2

Presentation

Answer 2

• rectal bleeding
• mucus discharge
• tenesmus
• change in bowel habit

Question 3

RF

Answer 3

• increasing age
• FHx (FAP - familial adenomatous polyposis)
• previous history of polyps
• male gender

Question 4

Treatment

Answer 4

endoscopic polypectomy

Diagnosis and excision of colonic polyps is undertaken endoscopically in the asymptomatic population following screening or incidental diagnosis, in order to histologically verify the absence of malignancy and also to prevent the excised polyp from becoming malignant in the future.

Question 5

Treatment in FAP

Answer 5

colectomy with ileorectal anastomosis + completion proctectomy

The large bowel may be carpeted in polyps that necessitate prophylactic colectomy to prevent colorectal cancer.

Question 6

Differentials

Answer 6

Colorectal cancer
Haemorrhoids
Anal fissure
Crohn's disease
Ulcerative colitis

Question 7

Follow up

Answer 7

surveillance colonoscopy as being appropriate 1 year after resection