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Case Report
A large and pedunculated inflammatory pseudotumor with pseudosarcomatous change of the cecum mimicking a malignant polyp: a case report and literature review
Jong Suk Oh, Hyung Wook Kim, Su Bum Park, Dae Hwan Kang, Cheol Woong Choi, Su Jin Kim, Hyeong Seok Nam, Dae Gon Ryu
Clin Endosc 2023;56(1):119-124.   Published online July 19, 2021
DOI: https://doi.org/10.5946/ce.2021.081
AbstractAbstract PDFPubReaderePub
Inflammatory pseudotumor (IPT) is a rare benign tumor of unknown etiology that can occur in almost any organ system. It has neoplastic features such as local recurrence, invasive growth, and vascular invasion, leading to the possibility of malignant sarcomatous changes. The clinical presentations of colonic IPT may include abdominal pain, anemia, a palpable mass, and intestinal obstruction. A few cases of colonic IPT have been reported, but colonic IPT with pedunculated morphology is very rare. Furthermore, since it can mimic malignant polyps, understanding the endoscopic findings of colonic IPT is important for proper treatment. Herein, we present a case of colonic IPT with pseudosarcomatous changes, presenting as a large polyp, mimicking a malignant polyp in the cecum, along with a literature review.
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Original Article
Clipping for the Prevention of Immediate Bleeding after Polypectomy of Pedunculated Polyps: A Pilot Study
Sun-Jin Boo, Jeong-Sik Byeon, Seon Young Park, Jong Sun Rew, Da Mi Lee, Sung Jae Shin, Dong Uk Kim, Geum Am Song
Clin Endosc 2012;45(1):84-88.   Published online March 31, 2012
DOI: https://doi.org/10.5946/ce.2012.45.1.84
AbstractAbstract PDFPubReaderePub
Background/Aims

Immediate postpolypectomy bleeding (IPPB) increases the procedure time and it may disturb performing a safe polypectomy. The purpose of this study is to investigate whether clipping before snare polypectomy of large pedunculated polyps is useful for the prevention of IPPB.

Methods

This is a single arm, pilot study. We enrolled patients with pedunculated colorectal polyps that were 1 cm in size or more from 4 university hospitals between June 2009 and June 2010. Clips were applied at the stalk and snare polypectomy was then performed. The complications, including IPPB, were investigated.

Results

Fifty six pedunculated polyps in 47 patients (Male:Female=36:11; age, 56±11 years) were included. The size of the polyp heads was 17±8 mm. Tubular adenoma was most common (57%). The number of clips used before snare polypectomy was 2±0.5. The procedure was successful in all cases. IPPB occurred in 2 cases (3.6%), and both of these were managed by additional clipping. Delayed bleeding occurred in another one case (1.8%), which improved with conservative treatment. No perforation occurred.

Conclusions

We suggest that clipping before snare polypectomy of pedunculated polyps may be an easy and effective technique for the prevention of IPPB, and this should be confirmed in large scale, prospective, controlled studies.

Citations

Citations to this article as recorded by  
  • A novel technique using endoscopic band ligation for removal of long-stalked (>10 mm) pedunculated colon polyps
    Hyun Ho Choi, Chang Whan Kim, Hyung-Keun Kim, Sang Woo Kim, Sok Won Han, Kyung Jin Seo, Hiun-Suk Chae
    Saudi Journal of Gastroenterology.2021; 27(5): 296.     CrossRef
  • Endoscopic polypectomy devices
    Vinay Chandrasekhara, Nikhil A. Kumta, Barham K. Abu Dayyeh, Manoop S. Bhutani, Pichamol Jirapinyo, Kumar Krishnan, John T. Maple, Joshua Melson, Rahul Pannala, Mansour A. Parsi, Amrita Sethi, Guru Trikudanathan, Arvind J. Trindade, David R. Lichtenstein
    VideoGIE.2021; 6(7): 283.     CrossRef
  • Prophylactic clip application for large pedunculated polyps before snare polypectomy may decrease immediate postpolypectomy bleeding
    Jae Seung Soh, Myeongsook Seo, Kyung-Jo Kim
    BMC Gastroenterology.2020;[Epub]     CrossRef
  • Management of colonic polyps: an advancing discipline
    Amir Klein, Michael J. Bourke
    ANZ Journal of Surgery.2017; 87(5): 327.     CrossRef
  • Massive post‐polypectomy hemorrhage: Successful tulip‐bundle technique with endoloop for hemostasis
    Hsu‐Heng Yen, Chia‐Wei Yang, Shun‐Sheng Wu, Maw‐Soan Soon
    Advances in Digestive Medicine.2016; 3(3): 128.     CrossRef
  • Advanced Polypectomy and Resection Techniques
    Amir Klein, Michael J. Bourke
    Gastrointestinal Endoscopy Clinics of North America.2015; 25(2): 303.     CrossRef
  • Comparison of clipping with and without epinephrine injection for the prevention of post‐polypectomy bleeding in pedunculated colon polyps
    Yehyun Park, Tae Joo Jeon, Ji Young Park, Soo Jung Park, Jae Hee Cheon, Tae Il Kim, Won Ho Kim, Sung Pil Hong
    Journal of Gastroenterology and Hepatology.2015; 30(10): 1499.     CrossRef
  • Endoscopic haemostasis: An overview of procedures and clinical scenarios
    Jérémie Jacques, Romain Legros, Stanislas Chaussade, Denis Sautereau
    Digestive and Liver Disease.2014; 46(9): 766.     CrossRef
  • Advanced Endoscopic Resection of Colorectal Lesions
    Andres Sanchez-Yague, Tonya Kaltenbach, Gottumukkala Raju, Roy Soetikno
    Gastroenterology Clinics of North America.2013; 42(3): 459.     CrossRef
  • A Cost-efficacy Decision Analysis of Prophylactic Clip Placement After Endoscopic Removal of Large Polyps
    Neehar D. Parikh, Kyle Zanocco, Rajesh N. Keswani, Andrew J. Gawron
    Clinical Gastroenterology and Hepatology.2013; 11(10): 1319.     CrossRef
  • Fat Polyp, Thin Blood: Think Clip!
    Laura Borodyansky, John R. Saltzman
    Clinical Gastroenterology and Hepatology.2013; 11(10): 1333.     CrossRef
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A Case of Multiple Pedunculated Polypoid Gastric Carcinoids
Su Jin Jeon, M.D., Choon Wook Kim, M.D., Gyu Lee, M.D., Hoon Cho, M.D., Jae Hyeon Moon, M.D., Yeong Muk Kim, M.D. and Joon Sang Lee, M.D.
Korean J Gastrointest Endosc 2004;29(3):133-136.   Published online September 30, 2004
AbstractAbstract PDF
Gastric carcinoids usually appear as a single polypoid tumor or yellowish rounded submucosal tumor in the fundus or body of the stomach. Multiple gastric carcinoids are associated with pernicious anemia, chronic atrophic gastritis and Zollinger-Ellison syndrome. These are believed to be due to hypergastrinemia. In Korea, carcinoids usually appear as single round-based submucosal tumor or sessile polyps. Multiple pedunculated polypoid carcinoids were rarely reported. A 27-year old woman was admitted to our hospital due to melena. The endoscopy revealed multiple pedunculated polypoid lesions in the fundus and body, predominantly in Yamada type III and IV. The histopathologic examination revealed the diagnosis of gastric carcinoid tumors. Serum fasting gastrin level was normal. We report a case of multiple pedunculated polypoid gastric carcinoids without atrophic gastritis or hypergastrinemia with a review of relevant literatures.

(Korean J Gastrointest Endosc 2004;29:133⁣136)

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