Obstructive Giant Inflammatory Polyp of the Colon in Ulcerative Colitis.

Inflammatory polyps, also known as pseudo-polyps, are a common benign condition affecting 10-20% of patients with inflammatory bowel disease. Chronic, repeated inflammation and ulceration associated with healing lead to the formation of polyp-like structures in the colon. Although there are no common symptoms accompanying these pseudo-polyps, they can present with anemia, weight loss, diarrhea, intussusception, palpable mass, abdominal pain, discomfort, and melena, not to mention bowel obstruction that happens infrequently. Finally, it is important to recognize giant inflammatory polyps as they may occasionally be mistaken for colon cancer, leading to unnecessary surgical interventions. We present the case of a 38-year-old woman who was diagnosed with ulcerative colitis 10 years back, treated with oral mesalamine for five years, and had no follow-up after this period. She came to our clinic complaining of recurrent obstructive symptoms for a few months. Examination shows tenderness in the left lower quadrant with normal vital signs and bowel sounds.

Characteristics of adenomatous colorectal polyps among a Saudi population.

Objectives: Colorectal cancer is a common cause of cancer-related mortality in KSA with a rising incidence. Although adenomatous polyps are well-recognized as precursors of colorectal cancer, local data are scarce. Therefore, in this study, we aimed to evaluate the characteristics of adenomatous colon polyps in the Saudi population. Methods: We retrospectively reviewed the electronic databases of all patients who underwent colonoscopy for any indication between January 2015 and December 2019 at a tertiary care hospital. This study included adult patients who were found to have colorectal polyps with identified histopathology reports. We collected clinical and pathological data, including patient age, sex, and histopathological polyp characteristics. A p-value <0.05 was considered significant for descriptive and analytical statistics. Results: A total of 184 patients with colorectal polyps with identified histopathology reports were included in the analysis. Of these, 130 (70.6%) patients were aged 50 years or older, and 135 (73.3%) were male. Among all polyps, 127 (69%) were adenomatous, 31 (16.8%) were hyperplastic, and 24 (13%) were inflammatory. For adenomatous polyps, 31 (24.4%) were observed in patients younger than 50 years, and high-grade dysplasia was observed in 23 (18%) polyps. Among patients with adenomatous polyps, the anatomical location was as follows: 27 (23%) in the cecum/ascending colon, 12 (9%) in the transverse colon, 45 (35%) in the descending/sigmoid colon, 25 (19%) in the rectum, and 18 (14%) at multiple sites. Age >50 years was significantly associated with adenomatous polyps (P = 0.03). Conclusion: Approximately one-third of adenomatous polyps were detected proximal to the splenic flexure. Although adenomatous polyps were significantly associated with increasing age, 24% were observed in patients younger than 50 years of age. This finding supports the current recommendation to start screening at the age of 45.